| Thorson Dentistry For Kids | |
|
159 Longview Dr Ste A Destrehan LA 70047 | |
| (985) 307-0072 | |
| Not Available |
| Full Name | Thorson Dentistry For Kids |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 159 Longview Dr Ste A, Destrehan, Louisiana |
| Authorized Official Name and Position | Joey Keener (OFFICE MANAGER) |
| Authorized Official Contact | 9853070072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thorson Dentistry For Kids 159 Longview Dr Ste A Destrehan LA 70047-5076 Ph: (985) 307-0072 | Thorson Dentistry For Kids 159 Longview Dr Ste A Destrehan LA 70047 Ph: (985) 307-0072 |
| NPI Number | 1124507611 |
|---|---|
| Provider Enumeration Date | 08/07/2018 |
| Last Update Date | 08/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124507611 | NPI | - | NPPES |
| 1861227 | Medicaid | LA | |
| 6122 | Other | LA | STATE LICENSE |
| 26622 | Medicaid | LA | |
| 28782 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Plantation Road Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Plantation Rd, Destrehan, LA 70047 Phone: 985-764-1148 | |
Owens Family Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 Longview Dr, Suite 8, Destrehan, LA 70047 Phone: 985-764-1615 Fax: 985-764-1617 |