| Louisiana Dental Center | |
|
14243 Us Highway 190 Boutte LA 70039 | |
| (985) 785-0488 | |
| Not Available |
| Full Name | Louisiana Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14243 Us Highway 190, Boutte, Louisiana |
| Authorized Official Name and Position | Joseph R Lacoste (OWNER) |
| Authorized Official Contact | 9853450240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Dental Center 14243 Us Highway 190 Boutte LA 70039 Ph: (985) 785-0488 | Louisiana Dental Center 14243 Us Highway 190 Boutte LA 70039 Ph: (985) 785-0488 |
| NPI Number | 1699090365 |
|---|---|
| Provider Enumeration Date | 04/06/2010 |
| Last Update Date | 04/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699090365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3427 (Louisiana) | Primary |
Glaser Family Practice Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13270 Highway 90, Boutte, LA 70039 Phone: 985-785-0123 Fax: 985-785-0125 |