# ASCENSION ORAL SURGERY, LLC

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

## Provider details

- **NPI number:** 1992051007
- **Authorized official:** DR. MARK RICHARD JOSEPHS DMD (ORAL AND MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (225) 744-2660

## Contact information

- **Practice address:** 16260 AIRLINE HWY, SUITE A, PRAIRIEVILLE, LA 70769-4272
- **Practice address phone:** (225) 744-2660
- **Practice address fax:** (225) 744-2666
- **Mailing address:** 16260 AIRLINE HWY, SUITE A, PRAIRIEVILLE, LA 70769-4272
- **Mailing address phone:** (225) 744-2660
- **Mailing address fax:** (225) 744-2666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 6296 | LA | Yes |

## Other

- **Enumeration date:** 07/25/2012
- **Last updated:** 07/25/2012