| Family Dentistry Of Bogalusa | |
|
400 Louisiana Ave Bogalusa LA 70427-3323 | |
| (985) 735-7372 | |
| (985) 732-5944 |
| Full Name | Family Dentistry Of Bogalusa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 400 Louisiana Ave, Bogalusa, Louisiana |
| Authorized Official Name and Position | Charlie P Ilawan (OWNER) |
| Authorized Official Contact | 9857357372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dentistry Of Bogalusa 400 Louisiana Ave Bogalusa LA 70427-3323 Ph: (985) 735-7372 | Family Dentistry Of Bogalusa 400 Louisiana Ave Bogalusa LA 70427-3323 Ph: (985) 735-7372 |
| NPI Number | 1578777108 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578777108 | NPI | - | NPPES |
| 1880949 | Medicaid | LA | |
| 09014606 | Medicaid | MS | |
| 971021 | Other | LA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4361 (Louisiana) | Primary |
Louisiana Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 Memphis St, Bogalusa, LA 70427 Phone: 985-735-0078 | |
Gary A Parker Dds Apdc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Austin St, Bogalusa, LA 70427 Phone: 985-735-7653 Fax: 985-735-7688 |