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General NPI Number Information
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NPI Number | 1639508302
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Entity Type | Organization
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Legal Business Name | JOSHUA K. GIROD, DDS, LLC
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 318 E CORNERVIEW
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-644-2183
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Fax | 225-647-6975
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Provider Business Mailing Address
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Address Line | 17398 E AUTUMN DR
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769
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Country | US
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Telephone | 225-938-9639
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JOSHUA KEITH GIROD
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Credential | DDS
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Telephone | 225-644-2183
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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 | 6194
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License Number State | LA
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