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NPI Code Detail

MEDICARE: MID CITY SMILES FAMILY DENTISTRY

MEDICARE: MID CITY SMILES FAMILY DENTISTRY
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
11223G0001XGeneral Practice Dentistry6564LA
21223G0001XGeneral Practice Dentistry6293LA
31223G0001XGeneral Practice Dentistry5228LA

General Provider Information

NPI Number : 1720591043
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID CITY SMILES FAMILY DENTISTRY
Provider Business Mailing Address
First Line : 3625 CANAL STREET
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119
Country : US
Telephone Number : 504-485-6575
Fax Number :
Provider Business Practice Location Address
First Line : 3625 CANAL STREET
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119
Country : US
Telephone Number : 504-485-6575
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARK ANDERSON
Credential : D.D.S.
Telephone Number : 504-485-6575
Provider Enumeration Date : 11/08/2017
Last Update Date : 11/08/2017

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Directions to “MID CITY SMILES FAMILY DENTISTRY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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