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Individual

DR. JUDE PAUL FAIRCHILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1837 W PRIEN LAKE RD, LAKE CHARLES, LA 70605-1223
(337) 478-2805
(337) 478-1837
Mailing address
1837 W PRIEN LAKE RD, LAKE CHARLES, LA 70605-1223
(337) 478-2805
(337) 478-1837

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5990
LA

Other

Enumeration date
08/06/2012
Last updated
08/06/2012
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