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Organization
NORTHLAKE ORAL AND FACIAL SURGERY LLC
Active
Organization
NORTHLAKE ORAL AND FACIAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN RIAS BROWN MD, DMD (SOLE MEMBER)
(985) 643-1010
Entity
Organization
Contact information
Practice address
1271 7TH ST, SLIDELL, LA 70458-2041
(985) 643-1010
Mailing address
1271 7TH ST, SLIDELL, LA 70458-2041
(985) 643-1010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6298
LA
Other
Enumeration date
10/01/2012
Last updated
11/02/2012
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