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General NPI Number Information
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NPI Number | 1366829673
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Entity Type | Organization
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Legal Business Name | LACOUR DENTAL ASSOCIATES
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 719 E AIRPORT AVE #A
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City | BATON ROUGE
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State | LA
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Zip | 70806-6558
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Country | US
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Telephone | 225-924-3369
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Fax | 225-924-3387
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Provider Business Mailing Address
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Address Line | 719 E AIRPORT AVE #A
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City | BATON ROUGE
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State | LA
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Zip | 70806-6558
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Country | US
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Telephone | 225-924-3369
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Fax | 225-924-3387
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CHAD A LACOUR
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Credential | DDS
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Telephone | 225-757-8450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2798
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5037
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License Number State | LA
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