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3708 4th St Suite 103 Harvey LA 70058-2856 | |
| (504) 309-7830 | |
| (504) 309-7833 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3708 4th St, Harvey, Louisiana |
| Authorized Official Name and Position | Julia Phung Trieu (PRESIDENT) |
| Authorized Official Contact | 5043097830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3708 4th St Suite 103 Harvey LA 70058-2856 Ph: (504) 309-7830 | 3708 4th St Suite 103 Harvey LA 70058-2856 Ph: (504) 309-7830 |
| NPI Number | 1194099903 |
|---|---|
| Provider Enumeration Date | 02/27/2012 |
| Last Update Date | 02/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194099903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 6022 (Louisiana) | Primary |
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