| Edmond J. Ganucheau, Jr. Dds, Apdc | |
|
2825 Houma Blvd Metairie LA 70006-6635 | |
| (504) 887-3121 | |
| Not Available |
| Full Name | Edmond J. Ganucheau, Jr. Dds, Apdc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2825 Houma Blvd, Metairie, Louisiana |
| Authorized Official Name and Position | Bryon C Ganucheau (PRESIDENT) |
| Authorized Official Contact | 5048873121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edmond J. Ganucheau, Jr. Dds, Apdc 2825 Houma Blvd Metairie LA 70006-6635 Ph: (504) 887-3121 | Edmond J. Ganucheau, Jr. Dds, Apdc 2825 Houma Blvd Metairie LA 70006-6635 Ph: (504) 887-3121 |
| NPI Number | 1942550470 |
|---|---|
| Provider Enumeration Date | 09/12/2012 |
| Last Update Date | 09/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942550470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4959 (Louisiana) | Primary |
| 1223G0001X | Dentist - General Practice | 5403 (Louisiana) | Secondary |
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