MEDICARE: DR. ANN MARGUERITE BEHRENDS D.D.S.

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	122300000X	Dentist	16951	TX
2	1223P0700X	Prosthodontics	16951	TX

General Provider Information

NPI Number	:	1477620664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN MARGUERITE BEHRENDS D.D.S.

Provider Business Mailing Address
First Line	:	7223 MISSISSIPPI AVE.
Second Line	:
City	:	FORT POLK
State	:	LA
Zip	:	71459
Country	:	US
Telephone Number	:	337-531-2327
Fax Number	:

Provider Business Practice Location Address
First Line	:	7223 MISSISSIPPI AVE.
Second Line	:	BLDG 1561
City	:	FORT POLK
State	:	LA
Zip	:	71459
Country	:	US
Telephone Number	:	337-532-2327
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	06/01/2023

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