Organization
KIDDER AND KIDDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN KIDDER DDS (DENTIST/OWNER)
(225) 761-8585
Entity
Organization
Contact information
Practice address
6535 PERKINS RD, BATON ROUGE, LA 70808-4259
(225) 761-8585
(225) 761-1979
Mailing address
6535 PERKINS RD, BATON ROUGE, LA 70808-4259
(225) 761-8585
(225) 761-1979
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5901
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-1801786
DENTAL PRACTICE
LA
Enumeration date
02/14/2018
Last updated
02/14/2018
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