Organization
SUSANNE O. CORE DMD PDC FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE O. CORE DMD (OWNER)
(985) 630-6906
Entity
Organization
Contact information
Practice address
73193 HWY 25, COVINGTON, LA 70435
(985) 630-6906
(985) 796-5315
Mailing address
73193 HWY 25, COVINGTON, LA 70435
(985) 630-6906
(985) 796-5315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2392
MS
122300000X
Dentist
3600
MS
Other
Enumeration date
09/23/2011
Last updated
06/23/2016
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