| Fleur De Lis Mobile Dental | |
|
11822 Justice Avenue #84 Baton Rouge LA 70816 | |
| (225) 767-5343 | |
| (225) 767-4009 |
| Full Name | Fleur De Lis Mobile Dental |
|---|---|
| Speciality | Dentist |
| Location | 11822 Justice Avenue #84, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Sally B Daly (OWNER) |
| Authorized Official Contact | 3038105619 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fleur De Lis Mobile Dental Po Box 40992 Baton Rouge LA 70835-0992 Ph: (225) 767-5343 | Fleur De Lis Mobile Dental 11822 Justice Avenue #84 Baton Rouge LA 70816 Ph: (225) 767-5343 |
| NPI Number | 1932645041 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 01/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932645041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3767-14 (Mississippi) | Primary |
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