Organization
ADH-PORT VINCENT, LLC
Active
Other names
Port Vincent Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS SUADI DDS (OWNER/DENTIST)
(225) 753-5885
Entity
Organization
Contact information
Practice address
18335 LA HIGHWAY 42, PORT VINCENT, LA 70726-8025
(225) 698-9510
Mailing address
15420 S HARRELLS FERRY RD, SUITE C, BATON ROUGE, LA 70816-2933
(225) 753-5885
(225) 753-5908
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4818
LA
Other
Enumeration date
09/28/2012
Last updated
01/29/2013
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