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General NPI Number Information
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NPI Number | 1962065367
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Entity Type | Individual
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Provider Name | KACEY F GUILLORY DDS
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Gender | Female
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Dates
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Enumeration Date | 04/21/2019
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 2240 VETERANS MEMORIAL BLVD
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City | KENNER
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State | LA
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Zip | 70062-5673
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Country | US
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Telephone | 504-666-9358
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Fax |
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Provider Business Mailing Address
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Address Line | 140 FRANCOIS DR
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City | LAFAYETTE
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State | LA
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Zip | 70507-9735
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Country | US
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Telephone | 337-412-8996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6959
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License Number State | LA
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