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Organization
PAMELA DAIGLE DDS LLC
Active
Organization
PAMELA DAIGLE DDS LLC
Active
Other names
Off The Trace Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA PONCE DE LEON DAIGLE DDS (OWNER/MANAGER)
(985) 326-1711
Entity
Organization
Contact information
Practice address
2130 GAUSE BLVD W, SLIDELL, LA 70460-4118
(985) 326-1711
Mailing address
1 SAINT ANN DR # 8645, MANDEVILLE, LA 70471-3204
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2022
Last updated
03/12/2022
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