Organization
LANE EDDLEMAN, DDS, LLC
Active
Other names
EDDLEMAN DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (PAYER ENROLLMENT MANAGER)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2511 BROADMOOR BLVD, MONROE, LA 71201
(318) 322-2013
(318) 322-2048
Mailing address
2511 BROADMOOR BLVD, MONROE, LA 71201
(318) 322-2013
(318) 322-2048
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855626
—
LA
05
—
1860590
—
LA
Enumeration date
01/27/2015
Last updated
10/07/2025
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