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Organization

LAKE AREA DENTISTRY-DEQUINCY, LLC

Active
Other names
Lake Area Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFERY ALLEN HENNIGAN DDS (OWNER/DENTIST)
(337) 786-6221
Entity
Organization

Contact information

Practice address
824 W 4TH ST, DEQUINCY, LA 70633
(337) 786-6221
Mailing address
824 W 4TH ST, DEQUINCY, LA 70633
(337) 786-6221

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
LA-6269
LA

Other

Enumeration date
12/14/2016
Last updated
12/14/2016
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