Organization
BAYOU SMILES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH P BRAUD JR. MSPH, DDS (OWNER)
(337) 367-1271
Entity
Organization
Contact information
Practice address
1205 VICTOR II BLVD, MORGAN CITY, LA 70380
(337) 367-1721
(337) 365-5137
Mailing address
1205 VICTOR II BLVD, MORGAN CITY, LA 70380
(337) 367-1271
(337) 365-5137
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6019
LA
1223G0001X
General Practice Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1860191
—
LA
Enumeration date
12/18/2012
Last updated
01/15/2013
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