Individual
MRS. MARY SEALE CHURCHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3632 COMMON ST, LAKE CHARLES, LA 70607-1744
(337) 478-4022
(337) 478-4017
Mailing address
3632 COMMON ST, LAKE CHARLES, LA 70607
(337) 478-4022
(337) 478-4017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5662
LA
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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