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Dental Providers Dentist General Practice

Provider NPI: 1598060642

Organization Information:
Organization Name:  OPELOUSAS DENTAL LLC
Organization is not Subpart
Authorized Official:  BRIDGETTE MICHELLE VIDRINE  OWNER/MANAGER  337-942-3441

Practice Location:
506 N COURT ST  OPELOUSAS, LA 70570-5220 US
Tel: 337-942-3441  Fax: 337-942-3461

Business Mailing Address:
506 N COURT ST  OPELOUSAS, LA 70570-5220 US
Tel: 337-942-3441  Fax: 337-942-3461

NPI Information:
NPI: 1598060642
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N1223G0001XDental Providers
General Practice
N124Q00000XDental Providers
Dental Hygienist
N126800000XDental Providers
Dental Assistant
Y1223G0001XDental Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 1223G0001X





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