Organization
CHARLES L. ANZALONE, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES LANE ANZALONE SR. DDS (DENTIST)
(337) 783-2455
Entity
Organization
Contact information
Practice address
725 N AVENUE K, CROWLEY, LA 70526-3848
(337) 783-2455
(337) 783-3815
Mailing address
725 N AVENUE K, CROWLEY, LA 70526-3848
(337) 783-2455
(337) 783-3815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3522
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26512
—
LA
Enumeration date
07/14/2016
Last updated
07/14/2016
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