| Dr Robert E Spatafora, Llc | |
|
2212 Justice St Monroe LA 71201-3620 | |
| (318) 325-5764 | |
| (318) 325-7940 |
| Full Name | Dr Robert E Spatafora, Llc |
|---|---|
| Speciality | Dentist |
| Location | 2212 Justice St, Monroe, Louisiana |
| Authorized Official Name and Position | Robert E Spatafora (DENTIST) |
| Authorized Official Contact | 3183255764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Robert E Spatafora, Llc 2212 Justice St Monroe LA 71201-3620 Ph: (318) 325-5764 | Dr Robert E Spatafora, Llc 2212 Justice St Monroe LA 71201-3620 Ph: (318) 325-5764 |
| NPI Number | 1477032084 |
|---|---|
| Provider Enumeration Date | 08/14/2018 |
| Last Update Date | 05/08/2024 |
| Medicare PECOS PAC ID | 2860737244 |
|---|---|
| Medicare Enrollment ID | O20181213002161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477032084 | NPI | - | NPPES |
| 29653 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 3206 (Louisiana) | Secondary |
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