Organization
JEFFREY L SCHWAB DDS APDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LYNN SCHWAB DDS (PRESIDENT)
(985) 624-7707
Entity
Organization
Contact information
Practice address
875 PARK AVE, MANDEVILLE, LA 70448
(985) 624-7707
Mailing address
875 PARK AVE, MANDEVILLE, LA 70448
(985) 624-7707
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4007
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1840076
—
LA
01
—
A1947
BLUE CROSS BLUE SHIELD
LA
Enumeration date
12/12/2006
Last updated
08/22/2020
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