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Organization
PERIODONTICS AND IMPLANT CENTER LLC
Active
Organization
PERIODONTICS AND IMPLANT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE BRUNI DDS (OWNER)
(225) 767-2273
Entity
Organization
Contact information
Practice address
8202 KELWOOD AVE, BATON ROUGE, LA 70806-4801
(225) 767-2273
Mailing address
4451 BLUEBONNET BLVD, SUITE F, BATON ROUGE, LA 70809-9646
(225) 767-2273
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5315
LA
Other
Enumeration date
03/22/2013
Last updated
03/22/2013
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