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Organization
RUSSELL SCHAFER DENTAL CLINIC LLC
Active
Organization
RUSSELL SCHAFER DENTAL CLINIC LLC
Active
Other names
NOLA Dentures and General Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL SCHAFER (OWNER)
(985) 502-3314
Entity
Organization
Contact information
Practice address
816 BEHRMAN HWY, GRETNA, LA 70056-4546
(504) 392-5104
Mailing address
816 BEHRMAN HWY, GRETNA, LA 70056-4546
(504) 392-5104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/17/2023
Last updated
06/20/2023
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