Organization
COLBERT FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAHISA COLBERT (DENTIST)
(337) 234-0411
Entity
Organization
Contact information
Practice address
1006 SURREY ST, LAFAYETTE, LA 70501-6143
(337) 234-0411
Mailing address
1006 SURREY ST, LAFAYETTE, LA 70501-6143
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5321
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881821
—
LA
Enumeration date
03/19/2007
Last updated
08/22/2020
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