Healthcare Provider Details

I. General information

NPI: 1770235731
Provider Name (Legal Business Name): BATON ROUGE DENTAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10723 N OAK HILLS PKWY STE B
BATON ROUGE LA
70810-2968
US

IV. Provider business mailing address

10723 N OAK HILLS PKWY STE B
BATON ROUGE LA
70810-2968
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-1444
  • Fax:
Mailing address:
  • Phone: 225-769-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: CAESAR SWEIDAN
Title or Position: CEO
Credential: DDS
Phone: 985-778-0241