Individual
JOHNNY RAY BEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4905 WICHERS DR, UNIT A, MARRERO, LA 70072-3028
(504) 340-4888
(504) 340-4829
Mailing address
4905 WICHERS DR, UNIT A, MARRERO, LA 70072-3028
(504) 340-4888
(504) 340-4829
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4162
LA
Other
Enumeration date
10/03/2006
Last updated
10/28/2013
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