Organization
J DAVID BRANNEN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID BRANNEN DDS (OWNER)
(985) 785-6838
Entity
Organization
Contact information
Practice address
111 LAKEWOOD DR, SUITE A, LULING, LA 70070-3002
(985) 785-6838
Mailing address
111 LAKEWOOD DR, SUITE A, LULING, LA 70070-3002
(985) 785-6838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3931
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26298
—
LA
Enumeration date
03/17/2016
Last updated
03/17/2016
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