| Cecil C Gaddis Dds., A Professional Dental Corporation | |
|
2709 North First Street Jena LA 71342 | |
| (318) 992-6175 | |
| (318) 992-6197 |
| Full Name | Cecil C Gaddis Dds., A Professional Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 2709 North First Street, Jena, Louisiana |
| Authorized Official Name and Position | Cecil Clyde Gaddis (PRESIDENT) |
| Authorized Official Contact | 3189926175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cecil C Gaddis Dds., A Professional Dental Corporation P.o. Box 891 Jena LA 71342 Ph: (318) 992-6175 | Cecil C Gaddis Dds., A Professional Dental Corporation 2709 North First Street Jena LA 71342 Ph: (318) 992-6175 |
| NPI Number | 1609238336 |
|---|---|
| Provider Enumeration Date | 03/22/2016 |
| Last Update Date | 03/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609238336 | NPI | - | NPPES |
| 1826456 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Louisiana) | Primary |