Individual
TIMOTHY PAUL FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
149 N 3RD ST, EUNICE, LA 90535
(337) 457-1342
(337) 457-1354
Mailing address
149 N 3RD ST, EUNICE, LA 70535
(337) 457-1342
(337) 457-1354
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3628
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1836281
—
LA
Enumeration date
08/22/2006
Last updated
07/08/2007
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