Individual
BROOK TERESA THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1100 FLORIDA AVE, NEW ORLEANS, LA 70119-2715
(504) 619-8700
Mailing address
1144 FOCIS ST, METAIRIE, LA 70005-2220
(337) 258-4547
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7223
LA
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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