Charlie Buller Iii Dds | |
206 Thomson Ave. Iowa LA 70647-1179 | |
(337) 582-7225 | |
(337) 582-4867 |
Full Name | Charlie Buller Iii Dds |
---|---|
Speciality | Dentist |
Location | 206 Thomson Ave., Iowa, Louisiana |
Authorized Official Name and Position | Charlie Buller (OWNER) |
Authorized Official Contact | 3375827225 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Charlie Buller Iii Dds Po Box 1179 Iowa LA 70647-1179 Ph: (337) 582-7225 | Charlie Buller Iii Dds 206 Thomson Ave. Iowa LA 70647-1179 Ph: (337) 582-7225 |
NPI Number | 1255629390 |
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Provider Enumeration Date | 07/11/2011 |
Last Update Date | 07/11/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255629390 | NPI | - | NPPES |
1840220 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 4022 (Louisiana) | Primary |
122300000X | Dentist | 6173 (Louisiana) | Secondary |