# WALTER J. JUNG PROFESSIONAL DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Louisiana Oral & Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659404077
- **Authorized official:** DR. WALTER J JUNG DDS, PC (OWNER)
- **Authorized official phone:** (225) 767-7212

## Contact information

- **Practice address:** 8680 BLUEBONNET BLVD, SUITE C, BATON ROUGE, LA 70810-7825
- **Practice address phone:** (225) 767-7212
- **Practice address fax:** (225) 767-0945
- **Mailing address:** 8680 BLUEBONNET BLVD, SUITE C, BATON ROUGE, LA 70810-7825
- **Mailing address phone:** (225) 767-7212
- **Mailing address fax:** (225) 767-0945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5295 | LA | Yes |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 07/17/2008