Organization
CYPRESS BEND ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN STANFORD DDS (OWNER)
(337) 352-2363
Entity
Organization
Contact information
Practice address
106 RUE BASTILLE, LAFAYETTE, LA 70508
(337) 352-2363
Mailing address
106 RUE BASTILLE, LAFAYETTE, LA 70508
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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