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General NPI Number Information
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NPI Number | 1720957848
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Entity Type | Organization
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Legal Business Name | LABRY FAMILY DENTISTRY
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 100 TENNYSON DR
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City | BROUSSARD
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State | LA
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Zip | 70518-5359
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Country | US
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Telephone | 337-330-8480
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Fax | 337-330-8502
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Provider Business Mailing Address
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Address Line | 100 TENNYSON DR
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City | BROUSSARD
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State | LA
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Zip | 70518-5359
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Country | US
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Telephone | 337-330-8480
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Fax | 337-330-8502
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | JACQUE LABRY SR.
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Credential | DDS
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Telephone | 337-330-8480
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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 |
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License Number State |
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