| Laketown Dental | |
|
4134 Florida Ave Ste 101 Kenner LA 70065-2190 | |
| (504) 218-4444 | |
| (504) 218-4204 |
| Full Name | Laketown Dental |
|---|---|
| Speciality | Dentist |
| Location | 4134 Florida Ave Ste 101, Kenner, Louisiana |
| Authorized Official Name and Position | Jaclyn Duboue (DENTIST OWNER) |
| Authorized Official Contact | 5043902847 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laketown Dental Po Box 30458 New Orleans LA 70190-0458 Ph: (504) 218-4444 | Laketown Dental 4134 Florida Ave Ste 101 Kenner LA 70065-2190 Ph: (504) 218-4444 |
| NPI Number | 1245494814 |
|---|---|
| Provider Enumeration Date | 07/14/2008 |
| Last Update Date | 01/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245494814 | NPI | - | NPPES |
| 1856355 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5635 (Louisiana) | Primary |
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