Jacob R Diebold, Dds, Llc | |
7181 Us Highway 61 St. Francisville LA 70775 | |
(225) 635-4707 | |
(225) 635-2172 |
Full Name | Jacob R Diebold, Dds, Llc |
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Speciality | Clinic/center - Dental |
Location | 7181 Us Highway 61, St. Francisville, Louisiana |
Authorized Official Name and Position | Jacob Ryan Diebold (MANAGING MEMBER) |
Authorized Official Contact | 3186143273 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jacob R Diebold, Dds, Llc Po Box 1068 Saint Francisville LA 70775-1068 Ph: (225) 635-4707 | Jacob R Diebold, Dds, Llc 7181 Us Highway 61 St. Francisville LA 70775 Ph: (225) 635-4707 |
NPI Number | 1902286941 |
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Provider Enumeration Date | 06/04/2015 |
Last Update Date | 06/04/2015 |
Identifier | Type | State | Issuer |
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1902286941 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 6554 (Louisiana) | Primary |