Adam Berthelot
Dentist, General Practice in Covington, LA. Individual provider (NPI-1).
NPI number1396272480
StatusActive
Last updated in NPPESMay 19, 2017
Details
- NPI
- 1396272480
- Entity type
- Individual (NPI-1)
- Name
- Adam Berthelot
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 19, 2017
- Last updated
- May 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 6741 | LA | Yes |
Practice location
842 Collins BlvdCovington, LA 70433-2759
Phone 985-809-1889
Mailing address
6005 Chateau Loire CirMandeville, LA 70448-7055
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