Organization
CFDM LLC
Active
Other names
Concord Family Dental Metairie LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LACEY ANDREOTTA DDS (OWNER)
(504) 455-5410
Entity
Organization
Contact information
Practice address
2636 ATHANIA PKWY, METAIRIE, LA 70002
(504) 455-5410
(504) 455-5410
Mailing address
2636 ATHANIA PKWY, METAIRIE, LA 70002
(504) 455-5410
(504) 455-5410
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1863505
—
LA
Enumeration date
01/23/2023
Last updated
12/13/2023
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