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General NPI Number Information
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NPI Number | 1316497829
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Entity Type | Organization
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Legal Business Name | JAMES M. PITTMAN, INC.
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Dates
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Enumeration Date | 10/07/2016
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 12183 RICHARDSON HILL RD
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City | FOLSOM
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State | LA
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Zip | 70437-5926
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Country | US
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Telephone | 985-796-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 12183 RICHARDSON HILL RD
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City | FOLSOM
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State | LA
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Zip | 70437-5926
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Country | US
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Telephone | 985-796-8500
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Fax |
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Authorized Official
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Title or Position | D.D.S.
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Name | DR. JAMES M PITTMAN
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Credential |
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Telephone | 985-796-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2248
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License Number State | LA
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