| Imagdent Acadiana, L.l.c. | |
|
1225 Coolidge Blvd Lafayette LA 70503-2620 | |
| (337) 232-5332 | |
| (337) 232-5655 |
| Full Name | Imagdent Acadiana, L.l.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1225 Coolidge Blvd, Lafayette, Louisiana |
| Authorized Official Name and Position | Douglas Hunter Perret (OWNER) |
| Authorized Official Contact | 3372325332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagdent Acadiana, L.l.c. 1225 Coolidge Blvd Lafayette LA 70503-2620 Ph: (337) 232-5332 | Imagdent Acadiana, L.l.c. 1225 Coolidge Blvd Lafayette LA 70503-2620 Ph: (337) 232-5332 |
| NPI Number | 1063681914 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 02/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063681914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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