| Eddleman Dental | |
|
2511 Broadmoor Blvd Monroe LA 71201 | |
| (318) 322-2013 | |
| (318) 322-2048 |
| Full Name | Eddleman Dental |
|---|---|
| Speciality | Dentist |
| Location | 2511 Broadmoor Blvd, Monroe, Louisiana |
| Authorized Official Name and Position | Jenny Garcia-rocha (PAYER ENROLLMENT MANAGER) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eddleman Dental 2511 Broadmoor Blvd Monroe LA 71201 Ph: (318) 322-2013 | Eddleman Dental 2511 Broadmoor Blvd Monroe LA 71201 Ph: (318) 322-2013 |
| NPI Number | 1588054779 |
|---|---|
| Provider Enumeration Date | 01/27/2015 |
| Last Update Date | 10/07/2025 |
| Certification Date | 10/07/2025 |
| Medicare PECOS PAC ID | 5890276091 |
|---|---|
| Medicare Enrollment ID | O20260225003599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588054779 | NPI | - | NPPES |
| 1855626 | Medicaid | LA | |
| 1860590 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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