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General NPI Number Information
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NPI Number | 1124840541
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Entity Type | Organization
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Legal Business Name | AFFORDABLE SMILES OF LACOMBE, LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 27403 US - 190 STE. A
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City | LACOMBE
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State | LA
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Zip | 70445
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Country | US
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Telephone | 985-218-9445
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Fax |
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Provider Business Mailing Address
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Address Line | 27403 US - 190 STE. A
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City | LACOMBE
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State | LA
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Zip | 70445
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Country | US
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Telephone | 985-218-9445
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Fax |
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | MRS. DANIELLE RICKARDS
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Credential |
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Telephone | 985-218-9445
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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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