MEDICARE: JOVIAN S. MONETTE, DDS, A PROFESSIONAL DENTAL CORPORATION

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

General Provider Information

NPI Number	:	1932812336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOVIAN S. MONETTE, DDS, A PROFESSIONAL DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	8847 VETERANS MEMORIAL BLVD STE 8
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-7707
Country	:	US
Telephone Number	:	504-466-2392
Fax Number	:

Provider Business Practice Location Address
First Line	:	8847 VETERANS MEMORIAL BLVD STE 8
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70003-7707
Country	:	US
Telephone Number	:	504-466-2392
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOVIAN S MONETTE
Credential	:	DDS
Telephone Number	:	504-466-2392

Provider Enumeration Date	:	12/30/2022
Last Update Date	:	12/30/2022

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