Nicole Suberville Wascom, D.D.S.
Dentist in Abita Springs, LA. Individual provider (NPI-1).
NPI number1982807632
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1982807632
- Entity type
- Individual (NPI-1)
- Name
- Nicole Suberville Wascom
- Credential
- D.D.S.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 8, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 5288 | LA | Yes |
Practice location
22464 Highway 435Abita Springs, LA 70420-2206
Phone 985-893-7835 · Fax 985-893-3867
Mailing address
22464 Highway 435Abita Springs, LA 70420-2206
Phone 985-893-7835 · Fax 985-893-3867
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