| Dr Edmund Jeansonne Jr Dds | |
|
111 Lakewood Dr Ste B Luling LA 70070-3002 | |
| (985) 785-8226 | |
| (985) 785-2288 |
| Full Name | Dr Edmund Jeansonne Jr Dds |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 111 Lakewood Dr Ste B, Luling, Louisiana |
| Authorized Official Name and Position | Dr Edmund E Jeansonne (OWNER) |
| Authorized Official Contact | 9857858226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Edmund Jeansonne Jr Dds 111 Lakewood Dr Ste B Luling LA 70070-3002 Ph: (985) 785-8226 | Dr Edmund Jeansonne Jr Dds 111 Lakewood Dr Ste B Luling LA 70070-3002 Ph: (985) 785-8226 |
| NPI Number | 1942402755 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942402755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 2215 (Louisiana) | Primary |
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