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General NPI Number Information
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NPI Number | 1033073440
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Entity Type | Organization
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Legal Business Name | DONALDSONVILLE DENTAL SERVICES LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 201 LESSARD ST
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City | DONALDSONVILLE
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State | LA
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Zip | 70346-2507
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Country | US
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Telephone | 225-473-8456
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Fax |
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Provider Business Mailing Address
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Address Line | 36465 SHADOW LN
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-3436
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Country | US
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Telephone | 225-978-9818
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | FLETCHER STAMPER SUTTON III
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Credential | DDS
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Telephone | 225-978-9818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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