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Organization
LSUHSC SCHOOL OF DENTISTRY
Active
Organization
LSUHSC SCHOOL OF DENTISTRY
Active
Other names
LSU Dental School
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN GALLO D.D.S. (ASSISTANT DEAN OF CLINICAL AFFAIRS)
(504) 941-8110
Entity
Organization
Contact information
Practice address
1100 FLORIDA AVENUE, NEW ORLEANS, LA 70119-2714
(504) 941-8110
(504) 941-8117
Mailing address
1100 FLORIDA AVENUE, NEW ORLEANS, LA 70119-2714
(504) 941-8110
(504) 941-8112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4618
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1846180
—
LA
05
—
1880400
—
LA
05
—
1881031
—
LA
Enumeration date
02/13/2007
Last updated
06/16/2010
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