Organization
LA DENTAL URGENT CARE LLC
Active
Other names
LAKETOWN Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACLYN DUBOUE D.D.S. (MANAGING MEMBER OF LLC/OWNER/PROVID)
(225) 926-0702
Entity
Organization
Contact information
Practice address
4021 W. E. HECK CT, I-L, BATON ROUGE, LA 70816
(225) 926-0702
(504) 218-4204
Mailing address
3121 MARYLAND AVE, KENNER, LA 70065
(504) 390-2847
(504) 218-4204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5635
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1880426
—
LA
Enumeration date
07/14/2008
Last updated
07/31/2025
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