Organization
CATAHOULA PARISH HOSPITAL DISTRICT NO. 2
Active
Other names
Medical Center Family Dentistry, ISLAND DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA K MIESCH MBA (CEO)
(318) 389-5727
Entity
Organization
Contact information
Practice address
307 CHISUM ST, SICILY ISLAND, LA 71368-4807
(318) 389-9941
(318) 389-4028
Mailing address
PO BOX 8, 307 CHISUM STREET, SICILY ISLAND, LA 71368-0008
(318) 389-5727
(318) 389-4028
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
5539
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855391
—
LA
05
—
1940801
—
LA
Enumeration date
01/24/2007
Last updated
05/15/2023
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