MEDICARE: DR. JANE M. BIRRIEL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	LA 4764	LA

General Provider Information

NPI Number	:	1275672180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE M. BIRRIEL D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 3433
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70381-3433
Country	:	US
Telephone Number	:	985-385-2992
Fax Number	:	985-385-2994

Provider Business Practice Location Address
First Line	:	1151 MARGUERITE ST
Second Line	:	SUITE 100A
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-1850
Country	:	US
Telephone Number	:	985-385-2992
Fax Number	:	985-385-2994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	11/15/2010

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