Exceptional Dental Of Watson, LLC
Dentist in Denham Springs, LA. Organization (NPI-2).
NPI number1982180279
StatusActive
Last updated in NPPESFeb 8, 2021
Details
- NPI
- 1982180279
- Entity type
- Organization (NPI-2)
- Legal business name
- Exceptional Dental Of Watson, LLC
- Organization subpart
- No
- Enumeration date
- Jul 19, 2018
- Certification date
- Feb 8, 2021
- Last updated
- Feb 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 5312 | LA | Yes |
Other names
- Exceptional Dental Of Louisiana (Former Legal Business Name)
Practice location
34659 La Highway 16Denham Springs, LA 70706-0667
Phone 504-232-6624
Mailing address
34659 La Highway 16Denham Springs, LA 70706-0667
Authorized official
Samantha Coats
Insurance Credentialing Manager
5046092599
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