# GARDNER WADE D.D.S. LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144364639
- **Authorized official:** DR. ALEX GARDNER WADE DDS (DENTIST)
- **Authorized official phone:** (917) 657-5233

## Contact information

- **Practice address:** 9828 BLUEBONNET BLVD, SUITE D, BATON ROUGE, LA 70810-6461
- **Practice address phone:** (225) 752-3407
- **Mailing address:** 560 W 43RD ST, APT. 35C, NEW YORK, NY 10036-4300
- **Mailing address phone:** (917) 657-5233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5527 | LA | Yes |

## Other

- **Enumeration date:** 02/16/2007
- **Last updated:** 08/22/2020