Individual
GREESIM LOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13730 MILLERVILLE GREENS BLVD STE 1, BATON ROUGE, LA 70816-1696
(225) 330-8871
Mailing address
4990 JAMESTOWN AVE UNIT 25, BATON ROUGE, LA 70808-3251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6792
LA
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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