Organization
THERIOT FAMILY DENTAL CARE II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CHARLES THERIOT DDS (OWNER DENTIST)
(337) 984-3408
Entity
Organization
Contact information
Practice address
112 CHURCH ALLEY, NEW IBERIA, LA 70560
(337) 369-6587
(337) 369-3815
Mailing address
112 CHURCH ALLEY, NEW IBERIA, LA 70560
(337) 369-6587
(337) 369-3815
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5429
LA
Other
Enumeration date
01/30/2007
Last updated
08/22/2020
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