| Gonzales Dental Clinic, Ltd. A Professional Dental Corporation | |
|
318 E Cornerview Street Gonzales LA 70737-3152 | |
| (225) 644-2183 | |
| (225) 647-6975 |
| Full Name | Gonzales Dental Clinic, Ltd. A Professional Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 318 E Cornerview Street, Gonzales, Louisiana |
| Authorized Official Name and Position | Carl Keith Girod (PRESIDENT) |
| Authorized Official Contact | 2256442183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gonzales Dental Clinic, Ltd. A Professional Dental Corporation 318 E Cornerview Street Gonzales LA 70737-3152 Ph: (225) 644-2183 | Gonzales Dental Clinic, Ltd. A Professional Dental Corporation 318 E Cornerview Street Gonzales LA 70737-3152 Ph: (225) 644-2183 |
| NPI Number | 1770622060 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770622060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | LA 3144 (Louisiana) | Primary |
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Gonzales Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 318 E Cornerview, Gonzales, LA 70737 Phone: 225-644-2183 Fax: 225-647-6975 | |
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