| Justin K Bonaventure Dental Offices, Llc | |
|
13702 Coursey Blvd, Bldg 10, Ste C Baton Rouge LA 70817-1370 | |
| (225) 936-3933 | |
| Not Available |
| Full Name | Justin K Bonaventure Dental Offices, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13702 Coursey Blvd, Bldg 10, Ste C, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Justin Bonaventure (OWNER/PRESIDENT) |
| Authorized Official Contact | 2259363933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Justin K Bonaventure Dental Offices, Llc 13702 Coursey Blvd, Bldg 10, Ste C Baton Rouge LA 70817-1370 Ph: (225) 936-3933 | Justin K Bonaventure Dental Offices, Llc 13702 Coursey Blvd, Bldg 10, Ste C Baton Rouge LA 70817-1370 Ph: (225) 936-3933 |
| NPI Number | 1659992865 |
|---|---|
| Provider Enumeration Date | 04/28/2020 |
| Last Update Date | 04/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659992865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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