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104 Cleco Dr Pineville LA 71360-5325 | |
| (337) 541-2260 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 104 Cleco Dr, Pineville, Louisiana |
| Authorized Official Name and Position | David Ashley (PRINCIPAL) |
| Authorized Official Contact | 2058701009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
511 Brookwood Blvd Homewood AL 35209-6801 Ph: () - | 104 Cleco Dr Pineville LA 71360-5325 Ph: (337) 541-2260 |
| NPI Number | 1861217358 |
|---|---|
| Provider Enumeration Date | 11/19/2024 |
| Last Update Date | 01/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861217358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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