Individual
DR. LISA CHURCHMAN BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
225 W ASCENSION ST, GONZALES, LA 70737-2803
(225) 644-4976
Mailing address
225 W ASCENSION ST, GONZALES, LA 70737-2803
(225) 644-4976
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4685
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881163
—
LA
Enumeration date
01/24/2007
Last updated
07/09/2007
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