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Organization
EDWIN L BERCIER IV DDS
Active
Organization
EDWIN L BERCIER IV DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN L BERCIER IV DDS (OWNER)
(337) 334-3581
Entity
Organization
Contact information
Practice address
300 N POLK ST, RAYNE, LA 70578-6551
(337) 334-3581
(337) 334-2812
Mailing address
PO BOX 804, RAYNE, LA 70578-0804
(337) 334-3581
(337) 334-2812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5548
LA
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855481
—
LA
Enumeration date
06/07/2011
Last updated
06/24/2011
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