Individual
DR. MARK WAYNE MILAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
104 EXCHANGE PL, LAFAYETTE, LA 70503-2571
(337) 237-5197
Mailing address
104 EXCHANGE PL, LAFAYETTE, LA 70503
(337) 237-5197
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4035
LA
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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