| Lane Eddleman, Dds, Llc | |
|
2511 Broadmoor Blvd Monroe LA 71201-2987 | |
| (318) 322-2013 | |
| (318) 322-2048 |
| Full Name | Lane Eddleman, Dds, Llc |
|---|---|
| Speciality | Dentist |
| Location | 2511 Broadmoor Blvd, Monroe, Louisiana |
| Authorized Official Name and Position | Wendi Garnett (OFFICE MANAGER) |
| Authorized Official Contact | 3183222013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lane Eddleman, Dds, Llc 2511 Broadmoor Blvd Monroe LA 71201-2987 Ph: (318) 322-2013 | Lane Eddleman, Dds, Llc 2511 Broadmoor Blvd Monroe LA 71201-2987 Ph: (318) 322-2013 |
| NPI Number | 1588054779 |
|---|---|
| Provider Enumeration Date | 01/27/2015 |
| Last Update Date | 01/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588054779 | NPI | - | NPPES |
| 1860590 | Medicaid | LA | |
| 1855626 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5562 (Louisiana) | Primary |
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