Individual
STEWART M GEGENHEIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
23138 WITTIE LN, ROBERT, LA 70455-1824
(504) 616-6213
Mailing address
23138 WITTIE LN, ROBERT, LA 70455-1824
(504) 616-6213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4352
LA
Other
Enumeration date
04/02/2010
Last updated
04/02/2010
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