Organization
LAKE AREA DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERY ALLEN HENNIGAN DDS (DENTIST/OWNER)
(337) 478-8470
Entity
Organization
Contact information
Practice address
700 W MCNEESE ST, LAKE CHARLES, LA 70605-5567
(337) 478-8470
Mailing address
700 W MCNEESE ST, LAKE CHARLES, LA 70605-5567
(337) 478-8470
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LA-6269
LA
Other
Enumeration date
09/15/2015
Last updated
03/07/2023
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