# LOUISIANA IMPLANTS AND DENTURES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619751427
- **Authorized official:** DR. BLAKE VIDRINE JR. DDS (DENTIST)
- **Authorized official phone:** (337) 581-5791

## Contact information

- **Practice address:** 10330 AIRLINE HWY STE A6, BATON ROUGE, LA 70816-4191
- **Practice address phone:** (225) 308-8000
- **Practice address fax:** (225) 308-8000
- **Mailing address:** 10330 AIRLINE HWY STE A6, BATON ROUGE, LA 70816-4191
- **Mailing address phone:** (225) 308-8000
- **Mailing address fax:** (225) 308-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2023
- **Last updated:** 08/22/2023