| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2526 Williams Blvd, Kenner, Louisiana |
| Authorized Official Name and Position | Kay Stanley Oplinger (VP OF OPERATIONS) |
| Authorized Official Contact | 9122237228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2526 Williams Blvd Kenner LA 70062 Ph: (912) 223-7228 | 2526 Williams Blvd Kenner LA 70062 Ph: (912) 223-7228 |
| NPI Number | 1184934846 |
|---|---|
| Provider Enumeration Date | 10/15/2010 |
| Last Update Date | 10/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184934846 | NPI | - | NPPES |
| 1880175 | Medicaid | LA | |
| 2109162 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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