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General NPI Number Information
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NPI Number | 1295837326
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Entity Type | Organization
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Legal Business Name | LSU HEALTH SCIENCES CENTER LSU FACULTY DENTAL PRACTICE
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3800 HOUMA BLVD SUITE 305
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City | METAIRIE
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State | LA
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Zip | 70006
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Country | US
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Telephone | 504-889-9893
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Fax | 504-889-9895
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Provider Business Mailing Address
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Address Line | 3800 HOUMA BLVD SUITE 305
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City | METAIRIE
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State | LA
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Zip | 70006
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Country | US
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Telephone | 504-889-9893
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Fax | 504-889-9895
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. SYLVIA D MORPHY
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Credential |
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Telephone | 504-889-9893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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