Phsc Dental Clinic | |
2914 Betin Ave Monroe LA 71201-7258 | |
(318) 323-4450 | |
(318) 323-4430 |
Full Name | Phsc Dental Clinic |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 2914 Betin Ave, Monroe, Louisiana |
Authorized Official Name and Position | Catherine M Tonore (CEO) |
Authorized Official Contact | 3183881250 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Phsc Dental Clinic Po Box 7495 Monroe LA 71211-7495 Ph: (318) 388-1250 | Phsc Dental Clinic 2914 Betin Ave Monroe LA 71201-7258 Ph: (318) 323-4450 |
NPI Number | 1053604892 |
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Provider Enumeration Date | 05/26/2011 |
Last Update Date | 04/15/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053604892 | NPI | - | NPPES |
2177427 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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