Individual provider · NPI-1

Dr. John Theodore Bercier, DDS

Dentist, General Practice · Lake Charles, LA

NPI number1366567653
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1366567653
Entity type
Individual (NPI-1)
Name
Dr. John Theodore Bercier
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Mar 19, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice4163LAYes

Practice location

3212 Enterprise Blvd
Lake Charles, LA 70601

Phone 337-478-6690 · Fax 337-477-7791

Mailing address

3212 Enterprise Blvd
Lake Charles, LA 70601

Phone 337-478-6690 · Fax 337-477-7791

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