| Northlake Oral And Facial Surgery Llc | |
|
1271 7th St Slidell LA 70458-2041 | |
| (985) 643-1010 | |
| Not Available |
| Full Name | Northlake Oral And Facial Surgery Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1271 7th St, Slidell, Louisiana |
| Authorized Official Name and Position | Nathan Rias Brown (SOLE MEMBER) |
| Authorized Official Contact | 9856431010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northlake Oral And Facial Surgery Llc 1271 7th St Slidell LA 70458-2041 Ph: (985) 643-1010 | Northlake Oral And Facial Surgery Llc 1271 7th St Slidell LA 70458-2041 Ph: (985) 643-1010 |
| NPI Number | 1689925539 |
|---|---|
| Provider Enumeration Date | 10/01/2012 |
| Last Update Date | 11/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689925539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 6298 (Louisiana) | Primary |
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