MEDICARE: DR. CATHERINE ANNE HEBERT 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	1223E0200X	Endodontics	3630	LA

General Provider Information

NPI Number	:	1205973518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE ANNE HEBERT DDS

Provider Business Mailing Address
First Line	:	4600 HIGHWAY 22
Second Line	:	SUITE 4
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-2891
Country	:	US
Telephone Number	:	985-626-0111
Fax Number	:	985-626-0164

Provider Business Practice Location Address
First Line	:	4600 HIGHWAY 22
Second Line	:	SUITE 4
City	:	MANDEVILLE
State	:	LA
Zip	:	70471-2891
Country	:	US
Telephone Number	:	985-626-0111
Fax Number	:	985-626-0164

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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