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Organization
TRENTON DENTAL CENTER LLC
Active
Organization
TRENTON DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA OVERSTREET (INSURANCE COORDINATOR)
(318) 255-7946
Entity
Organization
Contact information
Practice address
1605 N TRENTON ST, RUSTON, LA 71270-2354
(318) 255-7946
Mailing address
1605 N TRENTON ST, RUSTON, LA 71270-2354
(318) 255-7946
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5674
STATE LICENSES NUMBER
LA
Enumeration date
11/15/2018
Last updated
11/15/2018
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