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Organization

LOUISIANA IMPLANTS AND DENTURES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BLAKE VIDRINE JR. DDS (DENTIST)
(337) 581-5791
Entity
Organization

Contact information

Practice address
10330 AIRLINE HWY STE A6, BATON ROUGE, LA 70816-4191
(225) 308-8000
(225) 308-8000
Mailing address
10330 AIRLINE HWY STE A6, BATON ROUGE, LA 70816-4191
(225) 308-8000
(225) 308-8000

Taxonomy

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

Other

Enumeration date
08/22/2023
Last updated
08/22/2023
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