| Model Dentistry Greenwell Springs Llc | |
|
14127 Greenwell Springs Rd Ste A Greenwell Springs LA 70739-3305 | |
| (225) 261-0043 | |
| (225) 261-0046 |
| Full Name | Model Dentistry Greenwell Springs Llc |
|---|---|
| Speciality | Dentist |
| Location | 14127 Greenwell Springs Rd Ste A, Greenwell Springs, Louisiana |
| Authorized Official Name and Position | Lucy Elizabeth Raborn (OWNER) |
| Authorized Official Contact | 2252610043 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Model Dentistry Greenwell Springs Llc 14127 Greenwell Springs Rd Ste A Greenwell Springs LA 70739-3305 Ph: (225) 261-0043 | Model Dentistry Greenwell Springs Llc 14127 Greenwell Springs Rd Ste A Greenwell Springs LA 70739-3305 Ph: (225) 261-0043 |
| NPI Number | 1205676350 |
|---|---|
| Provider Enumeration Date | 05/28/2024 |
| Last Update Date | 05/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205676350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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