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1301 Eastridge Dr Suite 1 Slidell LA 70458-3018 | |
| (985) 643-8800 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1301 Eastridge Dr, Slidell, Louisiana |
| Authorized Official Name and Position | Joseph Robert Lacoste (OWNER) |
| Authorized Official Contact | 9853450240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1301 Eastridge Dr Suite 1 Slidell LA 70458-3018 Ph: (985) 643-8800 | 1301 Eastridge Dr Suite 1 Slidell LA 70458-3018 Ph: (985) 643-8800 |
| NPI Number | 1932228418 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932228418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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