Individual
DR. ANTHONY A. INDOVINA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5132 LAPALCO BLVD, 2ND FLOOR, MARRERO, LA 70072-4238
(504) 340-2401
(504) 340-2423
Mailing address
5132 LAPALCO BLVD, 2ND FLOOR, MARRERO, LA 70072-4238
(504) 340-2401
(504) 340-2423
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2650
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110423
CIGNA DMO
LA
05
—
1826502
—
LA
01
—
4013264
AETNA EPO
LA
01
—
600034
UNITED CONCORDIA
LA
01
—
689358
AETNA HMO
LA
01
—
A1577
BLUE CROSS FEDERAL
LA
Enumeration date
12/19/2006
Last updated
07/09/2007
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