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Organization

CENTRAL DENTAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB F HENDERSON D.D.S. (OWNER)
(225) 261-6645
Entity
Organization

Contact information

Practice address
11424 SULLIVAN RD BLDG B SUITE A, BATON ROUGE, LA 70818-3615
(225) 261-6645
(225) 262-9061
Mailing address
11424 SULLIVAN ROAD BLDG B SUITE A, BATON ROUGE, LA 70818
(225) 261-6645
(225) 262-9061

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5406
LA

Other

Enumeration date
12/05/2006
Last updated
07/14/2008
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