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Individual

DR. IRA ROBERT PITFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
103 SMART PLACE, STE B, SLIDELL, LA 70458
(985) 643-2616
(985) 643-2631
Mailing address
103 SMART PL, STE. B, SLIDELL, LA 70458-2039
(985) 643-2616
(985) 643-2631

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4334
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1843342
LA
Enumeration date
05/12/2008
Last updated
05/12/2008
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