| Oral & Maxillofacial Surgery Center Of South Louisiana Llc | |
|
363 Lakeview Ct Covington LA 70433-7515 | |
| (985) 687-1616 | |
| (888) 920-7457 |
| Full Name | Oral & Maxillofacial Surgery Center Of South Louisiana Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 363 Lakeview Ct, Covington, Louisiana |
| Authorized Official Name and Position | Joshua Brandner (OWNER) |
| Authorized Official Contact | 9856402236 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral & Maxillofacial Surgery Center Of South Louisiana Llc 363 Lakeview Ct Covington LA 70433-7515 Ph: (985) 687-1616 | Oral & Maxillofacial Surgery Center Of South Louisiana Llc 363 Lakeview Ct Covington LA 70433-7515 Ph: (985) 687-1616 |
| NPI Number | 1629642046 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629642046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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