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Organization
LSU HEALTH SCIENCES CENTER LSU FACULTY DENTAL PRACTICE
Active
Organization
LSU HEALTH SCIENCES CENTER LSU FACULTY DENTAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE H. SPEEGLE CPA (PRACTICE MANAGER)
(504) 941-8119
Entity
Organization
Contact information
Practice address
1100 FLORIDA AVE, BOX 131, NEW ORLEANS, LA 70119-2714
(504) 619-8721
(504) 941-8001
Mailing address
1100 FLORIDA AVE, BOX 131, NEW ORLEANS, LA 70119-2714
(504) 619-8721
(504) 941-8001
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
5003
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952702
—
LA
01
—
A8122
BLUE CROSS
LA
Enumeration date
05/02/2007
Last updated
07/23/2014
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