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General NPI Number Information
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NPI Number | 1558008078
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Entity Type | Individual
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Provider Name | ALLI BETH BLANCHARD DDS
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Gender | Female
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 2301 N HIGHWAY 190 STE 7
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City | COVINGTON
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State | LA
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Zip | 70433-9051
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Country | US
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Telephone | 985-892-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 142 BROTHERS CT
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City | PIERRE PART
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State | LA
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Zip | 70339-4473
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Country | US
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Telephone | 985-513-8089
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7055
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License Number State | LA
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