Dr. Bryant Louis Bourgeois, DDS
Dentist, General Practice in Gonzales, LA. Individual provider (NPI-1).
NPI number1407461981
StatusActive
Last updated in NPPESSep 11, 2020
Details
- NPI
- 1407461981
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bryant Louis Bourgeois
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 11, 2020
- Certification date
- Sep 10, 2020
- Last updated
- Sep 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 7136 | LA | Yes |
Practice location
13317 N BurnsideGonzales, LA 70737
Phone 225-644-4000
Mailing address
8727 Scarlett DrBaton Rouge, LA 70806-8529
Phone 225-776-7675
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