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General NPI Number Information
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NPI Number | 1952471161
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Entity Type | Organization
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Legal Business Name | DRS KING COATES AND NOLAN A PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1101 ROYAL AVE SUITE B
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City | MONROE
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State | LA
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Zip | 71201
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Country | US
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Telephone | 318-323-9655
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Fax | 318-323-9698
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Provider Business Mailing Address
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Address Line | 1101 ROYAL AVE SUITE B
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City | MONROE
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State | LA
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Zip | 71201
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Country | US
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Telephone | 318-323-9655
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Fax | 318-323-9698
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ELVERSON DEVILLE COATES JR.
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Credential | DDS
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Telephone | 318-323-9655
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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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