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Organization
DALE M TRAHAN DDS LLC
Active
Organization
DALE M TRAHAN DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERELLE R LEE (OFFICE MANAGER)
(337) 981-6882
Entity
Organization
Contact information
Practice address
102 GENEVIEVE DR, LAFAYETTE, LA 70503
(337) 981-6882
(337) 991-0542
Mailing address
102 GENEVIEVE DR, LAFAYETTE, LA 70503
(337) 981-6882
(337) 991-0542
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3209
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1832090
—
LA
01
—
4065755
BCBS OF TN
—
01
—
427647
UNITED CONCORDIA
—
01
—
TRZQD354
BCBS OF MA
—
Enumeration date
10/24/2006
Last updated
08/22/2020
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