Healthcare Provider Details
I. General information
NPI: 1659188191
Provider Name (Legal Business Name): LIT SMILES OF NEW ORLEANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10980 I 10 SERVICE RD
NEW ORLEANS LA
70127-2864
US
IV. Provider business mailing address
10980 I 10 SERVICE RD
NEW ORLEANS LA
70127-2864
US
V. Phone/Fax
- Phone: 225-383-3000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
BUTLER
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 225-247-1484