Organization
EXCEPTIONAL DENTAL OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA COATS (INSURANCE CREDENTIALING SPECILIST)
(504) 609-2599
Entity
Organization
Contact information
Practice address
1518 GALLERIA BLVD., 1518, METAIRIE, LA 70001-7000
(504) 609-2599
Mailing address
1 GALLERIA BLVD STE 1518, METAIRIE, LA 70001-2082
(504) 609-2599
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
=========
DENTIST
LA
Enumeration date
12/31/2018
Last updated
02/26/2021
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