MEDICARE: PLATT AND KIDDER

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	5901	LA
2	1223G0001X	General Practice Dentistry	3017	LA

General Provider Information

NPI Number	:	1710203807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLATT AND KIDDER

Provider Business Mailing Address
First Line	:	6535 PERKINS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4259
Country	:	US
Telephone Number	:	225-761-8585
Fax Number	:	225-761-1979

Provider Business Practice Location Address
First Line	:	6535 PERKINS RD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4259
Country	:	US
Telephone Number	:	225-761-8585
Fax Number	:	225-761-1979

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	RENNEA ALFONSO
Credential	:
Telephone Number	:	225-761-8585

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	04/14/2010

Similar Medicare Providers

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Practice Location Address:

6535 PERKINS RD
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1801112073 — DR. DUSTIN MITCHELL KIDDER D.D.S.
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Practice Location Address:

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Practice Location Address:

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Directions to “PLATT AND KIDDER ” Practice Location

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