| Lake Area Dentistry-carlyss | |
|
4985 Highway 27 S Sulphur LA 70665-7571 | |
| (337) 583-2756 | |
| Not Available |
| Full Name | Lake Area Dentistry-carlyss |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4985 Highway 27 S, Sulphur, Louisiana |
| Authorized Official Name and Position | Jeffery Hennigan (OWNER) |
| Authorized Official Contact | 3374788470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Area Dentistry-carlyss 4985 Highway 27 S Sulphur LA 70665-7571 Ph: (337) 583-2756 | Lake Area Dentistry-carlyss 4985 Highway 27 S Sulphur LA 70665-7571 Ph: (337) 583-2756 |
| NPI Number | 1043706252 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 07/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043706252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | LA-6269 (Louisiana) | Primary |
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