Organization
ANITA J GOURI DDS LLC
Active
Other names
Lafayette Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANITA J GOURI DDS (PRESIDENT)
(337) 443-9944
Entity
Organization
Contact information
Practice address
1512 CAMELLIA BLVD., LAFAYETTE, LA 70508
(337) 443-9944
(337) 981-7505
Mailing address
1512 CAMELLIA BLVD, LAFAYETTE, LA 70508
(337) 443-9944
(337) 981-7505
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5755
LA
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
02/09/2017
Last updated
08/08/2023
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