Healthcare Provider Details

I. General information

NPI: 1588721179
Provider Name (Legal Business Name): LOUIS P. NOGUES, III, DDS, A PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22464 HIGHWAY 435
ABITA SPRINGS LA
70420-2206
US

IV. Provider business mailing address

34026 SIVERD LN
SLIDELL LA
70460-3000
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-8712
  • Fax: 985-893-3867
Mailing address:
  • Phone: 225-223-7467
  • Fax: 985-726-0128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2074
License Number StateLA

VIII. Authorized Official

Name: KATHLEEN RYAN NOGUES
Title or Position: SECRETARY
Credential:
Phone: 225-223-7467