| Trenton Dental Center Llc | |
|
1605 N Trenton St Ruston LA 71270-2354 | |
| (318) 255-7946 | |
| Not Available |
| Full Name | Trenton Dental Center Llc |
|---|---|
| Speciality | Dentist |
| Location | 1605 N Trenton St, Ruston, Louisiana |
| Authorized Official Name and Position | Amanda Overstreet (INSURANCE COORDINATOR) |
| Authorized Official Contact | 3182557946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trenton Dental Center Llc 1605 N Trenton St Ruston LA 71270-2354 Ph: (318) 255-7946 | Trenton Dental Center Llc 1605 N Trenton St Ruston LA 71270-2354 Ph: (318) 255-7946 |
| NPI Number | 1053880443 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 11/15/2018 |
| Medicare PECOS PAC ID | 4981947223 |
|---|---|
| Medicare Enrollment ID | O20190530000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053880443 | NPI | - | NPPES |
| 5674 | Other | LA | STATE LICENSES NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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