Individual
DR. MARK STEVE DEROUEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2301 OLD JEANERETTE ROAD, NEW IBERIA, LA 70563
(337) 367-8910
(337) 367-8919
Mailing address
2301 OLD JEANERETTE ROAD, NEW IBERIA, LA 70563
(337) 367-8910
(337) 367-8919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4270
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1847202
—
LA
Enumeration date
03/15/2007
Last updated
07/09/2007
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