Organization
NELA DENTAL OF MONROE, LLC
Active
Other names
NELA Dental- Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VANCE COSTELLO D.D.S. (MANAGER)
(318) 737-0964
Entity
Organization
Contact information
Practice address
2016 TOWER DR, MONROE, LA 71201-5036
(318) 387-5732
Mailing address
2016 TOWER DR, MONROE, LA 71201-5036
(318) 387-5732
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
LA
Other
Enumeration date
07/17/2014
Last updated
03/09/2023
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