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General NPI Number Information
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NPI Number | 1962089789
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Entity Type | Organization
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Legal Business Name | LSU AMBULATORY SURGERY CENTER
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 1100 FLORIDA AVE 2ND FLOOR SUITE 2554
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City | NEW ORLEANS
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State | LA
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Zip | 70119-2743
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Country | US
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Telephone | 504-941-8820
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Fax | 504-941-8821
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Provider Business Mailing Address
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Address Line | 1100 FLORIDA AVE 2ND FLOOR SUITE 2554
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City | NEW ORLEANS
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State | LA
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Zip | 70119-2743
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Country | US
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Telephone | 504-941-8820
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Fax | 504-941-8821
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Authorized Official
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Title or Position | DEAN - LSU SCHOOL OF DENTISTRY
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Name | DR. ROBERT LAUGHLIN
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Credential | DMD
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Telephone | 504-889-9893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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