| Adh-port Vincent, Llc | |
|
18335 La Highway 42 Port Vincent LA 70726-8025 | |
| (225) 698-9510 | |
| Not Available |
| Full Name | Adh-port Vincent, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 18335 La Highway 42, Port Vincent, Louisiana |
| Authorized Official Name and Position | Carlos Suadi (OWNER/DENTIST) |
| Authorized Official Contact | 2257535885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adh-port Vincent, Llc 15420 S Harrells Ferry Rd Suite C Baton Rouge LA 70816-2933 Ph: (225) 753-5885 | Adh-port Vincent, Llc 18335 La Highway 42 Port Vincent LA 70726-8025 Ph: (225) 698-9510 |
| NPI Number | 1497006522 |
|---|---|
| Provider Enumeration Date | 09/28/2012 |
| Last Update Date | 01/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497006522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4818 (Louisiana) | Primary |