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General NPI Number Information
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NPI Number | 1386845063
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Entity Type | Organization
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Legal Business Name | JAMES M. FONTENOT DDS AND BARBARA D. FONTENOT DDS (A PROFESSIONAL COR)
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 619 CYPRESS ST
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City | SULPHUR
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State | LA
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Zip | 70663-5051
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Country | US
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Telephone | 337-527-3932
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Fax | 337-625-5031
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Provider Business Mailing Address
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Address Line | 619 CYPRESS ST
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City | SULPHUR
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State | LA
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Zip | 70663-5051
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Country | US
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Telephone | 337-527-3932
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Fax | 337-625-5031
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Authorized Official
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Title or Position | SECRETARY-TREASURER
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Name | DR. BARBARA D. FONTENOT
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Credential | DDS
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Telephone | 337-527-3932
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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 | 2102
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License Number State | LA
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