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Organization
CFDM LLC
Active
Organization
CFDM LLC
Active
Other names
Concord Family Dental Metairie LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LACEY ANDREOTTA DDS (OWNER)
(504) 455-5410
Entity
Organization
Contact information
Practice address
2636 ATHANIA PKWY, METAIRIE, LA 70002
(504) 455-5410
(504) 455-5410
Mailing address
2636 ATHANIA PKWY, METAIRIE, LA 70002
(504) 455-5410
(504) 455-5410
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1863505
—
LA
Enumeration date
01/23/2023
Last updated
12/13/2023
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