MEDICARE: ALICE HO

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	6498	LA

General Provider Information

NPI Number	:	1568880250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE HO

Provider Business Mailing Address
First Line	:	4508 CHATEAU DR
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-1510
Country	:	US
Telephone Number	:	504-241-8457
Fax Number	:	504-241-8540

Provider Business Practice Location Address
First Line	:	4141 BIENVILLE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-5149
Country	:	US
Telephone Number	:	504-900-1195
Fax Number	:	504-513-2062

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

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	04/07/2021

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Directions to “ ALICE HO ” Practice Location

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