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Organization

DOUGLAS M GEORGE DDS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS GEORGE DDS (OWNER)
(318) 348-4795
Entity
Organization

Contact information

Practice address
430 E PINE ST, PONCHATOULA, LA 70454-2544
(318) 348-4795
Mailing address
430 E PINE ST, PONCHATOULA, LA 70454-2544
(985) 386-8454
(985) 386-8467

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
04/09/2021
Last updated
06/08/2021
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