Organization
LSU HEALTH SCIENCES CENTER LSU FACULTY DENTAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE H. SPEEGLE CPA (PRACTICE MANAGER)
(504) 941-8119
Entity
Organization
Contact information
Practice address
1100 FLORIDA AVE, BOX 131, NEW ORLEANS, LA 70119-2714
(504) 619-8721
(504) 941-8001
Mailing address
1100 FLORIDA AVE, BOX 131, NEW ORLEANS, LA 70119-2714
(504) 619-8721
(504) 941-8001
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
5003
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952702
—
LA
01
—
A8122
BLUE CROSS
LA
Enumeration date
05/02/2007
Last updated
07/23/2014
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