Lake Area Dentistry | |
824 W 4th St Dequincy LA 70633 | |
(337) 786-6221 | |
Not Available |
Full Name | Lake Area Dentistry |
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Speciality | Clinic/center - Dental |
Location | 824 W 4th St, Dequincy, Louisiana |
Authorized Official Name and Position | Jeffery Allen Hennigan (OWNER/DENTIST) |
Authorized Official Contact | 3377866221 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Area Dentistry 824 W 4th St Dequincy LA 70633 Ph: (337) 786-6221 | Lake Area Dentistry 824 W 4th St Dequincy LA 70633 Ph: (337) 786-6221 |
NPI Number | 1598209207 |
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Provider Enumeration Date | 12/14/2016 |
Last Update Date | 12/14/2016 |
Identifier | Type | State | Issuer |
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1598209207 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | LA-6269 (Louisiana) | Primary |