Individual
MARK B. LAHAYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
100 PECAN ST, THIBODAUX, LA 70301-4808
(985) 446-0988
(985) 446-0039
Mailing address
100 PECAN ST, THIBODAUX, LA 70301-4808
(985) 446-0988
(985) 446-0039
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5412
LA
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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