Organization
EXCEPTIONAL DENTAL OF METAIRIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL BOURG (OWNER)
(504) 232-6624
Entity
Organization
Contact information
Practice address
1128 CLEARVIEW PKWY, METAIRIE, LA 70001-3418
(504) 900-1195
Mailing address
1128 CLEARVIEW PKWY, METAIRIE, LA 70001-3418
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5312
LA
Other
Enumeration date
05/13/2017
Last updated
04/07/2025
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