Individual
DR. SHANE MICHAEL BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
800 C M FAGAN DR, SUITE A, HAMMOND, LA 70403-6062
(504) 495-8035
Mailing address
1858 INGLESIDE DR, BATON ROUGE, LA 70808-1269
(504) 495-8056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5998
LA
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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