Organization
DUBOUE DENTAL LLC
Active
Other names
HDL Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN DUBOUE DDS (PRESIDENT)
(504) 390-2847
Entity
Organization
Contact information
Practice address
633 CARONDELET ST, NEW ORLEANS, LA 70130-3503
(504) 218-4444
(504) 218-4946
Mailing address
PO BOX 30458, NEW ORLEANS, LA 70190-0458
(504) 218-4444
(504) 218-4946
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5635
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1856355
—
LA
Enumeration date
08/04/2014
Last updated
08/04/2014
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