Healthcare Provider Details

I. General information

NPI: 1295449205
Provider Name (Legal Business Name): ANTHONY A INDOVINA DDS AND ROBERT M LAUGHLIN DMD ORAL AND MAXILLOFACIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/13/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5132 LAPALCO BLVD
MARRERO LA
70072-4268
US

IV. Provider business mailing address

5132 LAPALCO BLVD
MARRERO LA
70072-4268
US

V. Phone/Fax

Practice location:
  • Phone: 504-340-2401
  • Fax: 504-340-2423
Mailing address:
  • Phone: 504-340-2401
  • Fax: 504-340-2423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT M LAUGHLIN
Title or Position: OWNER
Credential: DMD
Phone: 504-340-2401