Healthcare Provider Details

I. General information

NPI: 1598020927
Provider Name (Legal Business Name): P DANIELLE CAUSEY D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5760 MONTICELLO DR
SAINT GABRIEL LA
70776-4412
US

IV. Provider business mailing address

5760 MONTICELLO DR P.O. BOX 209
SAINT GABRIEL LA
70776-4412
US

V. Phone/Fax

Practice location:
  • Phone: 225-642-9676
  • Fax: 225-642-9696
Mailing address:
  • Phone: 225-642-9676
  • Fax: 225-642-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6318
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: