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18335 La Highway 42 Port Vincent LA 70726-8025 | |
(225) 698-9510 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 18335 La Highway 42, Port Vincent, Louisiana |
Authorized Official Name and Position | Carlos Suadi (OWNER/DENTIST) |
Authorized Official Contact | 2257535885 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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15420 S Harrells Ferry Rd Suite C Baton Rouge LA 70816-2933 Ph: (225) 753-5885 | 18335 La Highway 42 Port Vincent LA 70726-8025 Ph: (225) 698-9510 |
NPI Number | 1497006522 |
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Provider Enumeration Date | 09/28/2012 |
Last Update Date | 01/29/2013 |
Identifier | Type | State | Issuer |
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1497006522 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 4818 (Louisiana) | Primary |