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General NPI Number Information
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NPI Number | 1245876630
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Entity Type | Organization
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Legal Business Name | LOUISIANA DENTAL PROFESSIONALS, DONOVAN DRONET, DDS, A PROFESSIONAL DE
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 27686 JUBAN RD
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-8072
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Country | US
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Telephone | 225-367-2921
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Fax |
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Provider Business Mailing Address
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Address Line | 27686 JUBAN RD
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City | DENHAM SPRINGS
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State | LA
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Zip | 70726-8072
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Country | US
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Telephone | 253-046-5722
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Fax | 888-775-4580
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | JESSICA BRITT
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Credential |
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Telephone | 217-540-5100
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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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