Organization
NORTHSHORE DENTAL ASSOCIATES LLC
Active
Other names
Deepsouth Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JASON S CHAWLA DMD (OWNER)
(985) 774-8104
Entity
Organization
Contact information
Practice address
1160 HIGHWAY 51, PONCHATOULA, LA 70454-6365
(985) 386-9936
(985) 386-5712
Mailing address
1160 HIGHWAY 51, PONCHATOULA, LA 70454-6365
(985) 386-9936
(985) 386-5712
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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