| Concord Family Dental Metairie LLC | |
|
2636 Athania Pkwy Metairie LA 70002 | |
| (504) 455-5410 | |
| (504) 455-5410 |
| Full Name | Concord Family Dental Metairie LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2636 Athania Pkwy, Metairie, Louisiana |
| Authorized Official Name and Position | Lacey Andreotta (OWNER) |
| Authorized Official Contact | 5044555410 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Concord Family Dental Metairie LLC 2636 Athania Pkwy Metairie LA 70002 Ph: (504) 455-5410 | Concord Family Dental Metairie LLC 2636 Athania Pkwy Metairie LA 70002 Ph: (504) 455-5410 |
| NPI Number | 1154036291 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 12/13/2023 |
| Certification Date | 01/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154036291 | NPI | - | NPPES |
| 1863505 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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