Organization
SICARD ATCHAFALAYA DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAINA MARCANTEL (OFFICE MANAGER)
(985) 385-5423
Entity
Organization
Contact information
Practice address
1234 DAVID DR STE 106, MORGAN CITY, LA 70380-1371
(985) 385-5423
Mailing address
PO BOX 2118, MORGAN CITY, LA 70381-2118
(985) 385-5423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6062
DENTAL LICENSE NUMBER
LA
Enumeration date
05/01/2019
Last updated
05/01/2019
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