| Pinecrest Dental Clinic | |
|
100 Pinecrest Dr Attn: Paxton Oliver Pineville LA 71360-4276 | |
| (318) 487-5395 | |
| (318) 487-5463 |
| Full Name | Pinecrest Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 100 Pinecrest Dr, Pineville, Louisiana |
| Authorized Official Name and Position | Paxton E. Oliver (MR/DD REGIONAL ASSOC. ADMINISTRATOR) |
| Authorized Official Contact | 3184875395 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinecrest Dental Clinic Po Box 5191 Attn; Paxton Oliver Pineville LA 71361-5191 Ph: (318) 487-5395 | Pinecrest Dental Clinic 100 Pinecrest Dr Attn: Paxton Oliver Pineville LA 71360-4276 Ph: (318) 487-5395 |
| NPI Number | 1174852875 |
|---|---|
| Provider Enumeration Date | 12/09/2009 |
| Last Update Date | 12/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174852875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Louisiana) | Primary |
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