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Individual

DR. EDWARD LAWRENCE DONALDSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2960 E GAUSE BLVD, SLIDELL, LA 70461
(985) 641-3988
(985) 646-2536
Mailing address
2960 E GAUSE BLVD, SLIDELL, LA 70461
(985) 641-3988
(985) 646-2536

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2205
LA
1223P0221X
Pediatric Dentistry
297296
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1822051
LA
Enumeration date
12/04/2006
Last updated
07/08/2007
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