Individual
CHARLES COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3712 MACARTHUR BLVD, SUITE 201, NEW ORLEANS, LA 70114-6802
(504) 361-3277
Mailing address
4223 S DERBIGNY ST, NEW ORLEANS, LA 70125-5107
(504) 342-4733
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5013
LA
1223G0001X
General Practice Dentistry
Primary
5013
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1850136
—
LA
Enumeration date
05/06/2008
Last updated
06/17/2008
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