Organization
DEVEREUX AND NGUYEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK P DEVEREUX D.D.S., M.S. (OWNER AND ORTHODONTIST)
(504) 368-7513
Entity
Organization
Contact information
Practice address
2800 MANHATTAN BLVD., SUITE D, HARVEY, LA 70058-2904
(504) 368-7513
(504) 368-3932
Mailing address
2800 MANHATTAN BLVD., SUITE D, HARVEY, LA 70058-2904
(504) 368-7513
(504) 368-3932
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5714
LA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3676
LA
Other
Enumeration date
05/07/2007
Last updated
05/24/2013
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