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General NPI Number Information
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NPI Number | 1659401966
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Entity Type | Organization
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Legal Business Name | VINCI ORAL & FACIAL SURGERY INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7225 JEFFERSON HWY
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City | BATON ROUGE
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State | LA
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Zip | 70806
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Country | US
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Telephone | 225-923-3223
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Fax | 225-923-3511
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Provider Business Mailing Address
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Address Line | 7225 JEFFERSON HWY
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City | BATON ROUGE
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State | LA
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Zip | 70806
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Country | US
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Telephone | 225-923-3223
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Fax | 225-923-3511
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Authorized Official
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Title or Position | OWNER
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Name | DR. BAKER K VINCI
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Credential | ORAL SURGEON
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Telephone | 225-923-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | LA4742
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License Number State | LA
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