Individual
DR. SUSANNE O. CORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
73193 HWY 25, COVINGTON, LA 70435
(985) 630-6906
(985) 796-5315
Mailing address
73193 HWY 25, COVINGTON, LA 70435
(985) 630-6906
(985) 796-5315
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2392-88
MS
1223G0001X
General Practice Dentistry
Primary
4924
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060246
—
MS
Enumeration date
10/25/2006
Last updated
06/23/2016
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