Organization
SHANNON CANDID LOUISIANA, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SHANNON (DDS)
(860) 481-7631
Entity
Organization
Contact information
Practice address
804 MAIN ST, BATON ROUGE, LA 70802-5528
(860) 481-7631
Mailing address
804 MAIN ST, BATON ROUGE, LA 70802-5528
(860) 481-7631
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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