Individual
AMISHA A SURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
13707 COURSEY BLVD STE A, BATON ROUGE, LA 70817-1306
(225) 752-5241
Mailing address
13707 COURSEY BLVD STE A, BATON ROUGE, LA 70817-1306
(225) 752-5241
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7639
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/24/2017
Last updated
03/05/2025
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