Organization
OPELOUSAS DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIDGETTE MICHELLE VIDRINE D.D.S. (OWNER/MANAGER)
(337) 942-3441
Entity
Organization
Contact information
Practice address
506 N COURT ST, OPELOUSAS, LA 70570-5220
(337) 942-3441
(337) 942-3461
Mailing address
506 N COURT ST, OPELOUSAS, LA 70570-5220
(337) 942-3441
(337) 942-3461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5885
LA
1223G0001X
General Practice Dentistry
6040
LA
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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