| J David Brannen Dds | |
|
111 Lakewood Dr Suite A Luling LA 70070-3002 | |
| (985) 785-6838 | |
| Not Available |
| Full Name | J David Brannen Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 111 Lakewood Dr, Luling, Louisiana |
| Authorized Official Name and Position | John David Brannen (OWNER) |
| Authorized Official Contact | 9857856838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J David Brannen Dds 111 Lakewood Dr Suite A Luling LA 70070-3002 Ph: (985) 785-6838 | J David Brannen Dds 111 Lakewood Dr Suite A Luling LA 70070-3002 Ph: (985) 785-6838 |
| NPI Number | 1578924569 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 03/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578924569 | NPI | - | NPPES |
| 26298 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3931 (Louisiana) | Primary |
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