Organization
ORAL & MAXILLOFACIAL SURGERY CENTER OF SOUTH LOUISIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA BRANDNER DDS, MD (OWNER)
(985) 640-2236
Entity
Organization
Contact information
Practice address
363 LAKEVIEW CT, COVINGTON, LA 70433-7515
(985) 687-1616
(888) 920-7457
Mailing address
363 LAKEVIEW CT, COVINGTON, LA 70433-7515
(985) 687-1616
(888) 920-7457
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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