MEDICARE: EMILY JUDICE FOREMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	LA5726	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124164330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JUDICE FOREMAN DDS

Provider Business Mailing Address
First Line	:	300 DOUCET RD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-3400
Country	:	US
Telephone Number	:	337-989-1268
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 DOUCET RD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-3400
Country	:	US
Telephone Number	:	337-989-1268
Fax Number	:	337-989-1268

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	08/18/2008

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Directions to “ EMILY JUDICE FOREMAN DDS” Practice Location

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