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General NPI Number Information
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NPI Number | 1679062574
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Entity Type | Organization
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Legal Business Name | SCOTT V. LAW, D.M.D. LOUISIANA, A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 2800 MANHATTAN BLVD STE D
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City | HARVEY
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State | LA
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Zip | 70058-2904
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Country | US
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Telephone | 504-368-7513
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Fax |
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Provider Business Mailing Address
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Address Line | 5732 SALMEN ST STE C
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City | ELMWOOD
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State | LA
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Zip | 70123-2288
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Country | US
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Telephone | 800-864-1582
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT V LAW
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Credential | DMD
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Telephone | 800-864-1582
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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 | 6638
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License Number State | LA
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