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General NPI Number Information
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NPI Number | 1598986390
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Entity Type | Individual
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Provider Name | GRETCHEN JUNCKER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 3108 W ESPLANADE AVE N
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City | METAIRIE
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State | LA
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Zip | 70002-1750
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Country | US
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Telephone | 504-838-8118
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Fax | 504-837-3263
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Provider Business Mailing Address
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Address Line | 3108 W ESPLANADE AVE N
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City | METAIRIE
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State | LA
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Zip | 70002-1750
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Country | US
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Telephone | 504-838-8118
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Fax | 504-837-3263
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5728
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License Number State | LA
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