Organization
SULPHUR DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY JOSEPH BLANCHETTE (DENTIST / OWNER)
(337) 625-2671
Entity
Organization
Contact information
Practice address
2920 MAPLEWOOD DR, SULPHUR, LA 70663-6114
(337) 625-2671
Mailing address
2920 MAPLEWOOD DR, SULPHUR, LA 70663-6114
(337) 625-2671
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA3929
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26308
—
LA
Enumeration date
02/04/2015
Last updated
02/04/2015
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