| Louisiana Family Dental | |
|
17097 Airline Hwy Ste 106 Prairieville LA 70769-3576 | |
| (225) 402-4004 | |
| Not Available |
| Full Name | Louisiana Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17097 Airline Hwy Ste 106, Prairieville, Louisiana |
| Authorized Official Name and Position | Drake Jolivette (BUSINESS MANAGER) |
| Authorized Official Contact | 2254024004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Family Dental 17097 Airline Hwy Ste 106 Prairieville LA 70769-3576 Ph: (225) 402-4004 | Louisiana Family Dental 17097 Airline Hwy Ste 106 Prairieville LA 70769-3576 Ph: (225) 402-4004 |
| NPI Number | 1376024810 |
|---|---|
| Provider Enumeration Date | 08/23/2018 |
| Last Update Date | 09/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376024810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6602 (Louisiana) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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