Organization
DEEP SOUTH FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGG MAY (OWNER/DENTIST)
(985) 386-9936
Entity
Organization
Contact information
Practice address
1160 HWY 51 NORTH, PONCHATOULA, LA 70454
(985) 386-9936
Mailing address
1160 HWY 51 NORTH, PONCHATOULA, LA 70454
(985) 386-9936
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5258
LA
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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