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Organization
MARTHA V. ROUSSEL, DDS, LLC
Active
Organization
MARTHA V. ROUSSEL, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA VANDERSYPEN ROUSSEL DDS (DENTIST)
(225) 603-0590
Entity
Organization
Contact information
Practice address
8220 GOODWOOD BLVD STE 4B, BATON ROUGE, LA 70806-7741
(225) 603-0590
Mailing address
39450 QUAIL CREEK AVE, PRAIRIEVILLE, LA 70769-4829
(225) 603-0590
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5276
LA
Other
Enumeration date
06/14/2007
Last updated
06/16/2008
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