| Renaissance Dental Studio, Inc. | |
|
1419 Royal Ave Monroe LA 71201-5607 | |
| (318) 322-5904 | |
| (318) 322-3167 |
| Full Name | Renaissance Dental Studio, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1419 Royal Ave, Monroe, Louisiana |
| Authorized Official Name and Position | Grant S Glover (OWNER/DENTIST) |
| Authorized Official Contact | 3188213855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Dental Studio, Inc. 1419 Royal Ave Monroe LA 71201-5607 Ph: (318) 821-3855 | Renaissance Dental Studio, Inc. 1419 Royal Ave Monroe LA 71201-5607 Ph: (318) 322-5904 |
| NPI Number | 1346136520 |
|---|---|
| Provider Enumeration Date | 06/16/2025 |
| Last Update Date | 06/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346136520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Primary Health Services Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2914 Betin Ave, Monroe, LA 71201 Phone: 318-323-4450 Fax: 318-323-4430 | |
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