Individual
DR. DARRELL P BOURG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2521 AMES BLVD., STE. C, MARRERO, LA 70072-5154
(504) 340-9696
(504) 340-7207
Mailing address
2521 AMES BLVD., STE. C, MARRERO, LA 70072-5154
(504) 340-9696
(504) 340-7207
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5312
LA
Other
Enumeration date
03/21/2007
Last updated
02/08/2021
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