Organization
MELANCON FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW JOHN MELANCON DDS (OWNER/DENTIST)
(337) 837-1861
Entity
Organization
Contact information
Practice address
300 W MADISON ST, BROUSSARD, LA 70518-4518
(337) 837-1861
(337) 837-1278
Mailing address
300 W MADISON ST, BROUSSARD, LA 70518-4518
(337) 837-1861
(337) 837-1278
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5974
LA
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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