Organization
CHILDRENS DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFF DOUGLAS ELLARD DDS (OWNER/ PRESIDENT)
(225) 924-2010
Entity
Organization
Contact information
Practice address
541 SHADOWS LN, SUITE B, BATON ROUGE, LA 70806-6531
(225) 924-2010
(225) 926-5872
Mailing address
541 SHADOWS LN, SUITE B, BATON ROUGE, LA 70806-6531
(225) 924-2010
(225) 926-5872
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3507
LA
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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