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Organization
LOUISIANA FAMILY DENTAL
Active
Organization
LOUISIANA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DRAKE JOLIVETTE (BUSINESS MANAGER)
(225) 402-4004
Entity
Organization
Contact information
Practice address
11331 OLD HAMMOND HWY STE BC&D, BATON ROUGE, LA 70816-8461
(252) 566-3862
Mailing address
11331 OLD HAMMOND HWY STE BC&D, BATON ROUGE, LA 70816-8461
(225) 256-6386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6602
LA
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
08/23/2018
Last updated
08/06/2024
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