Individual
DR. CHARLES THOMAS MCCABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
250 MEADOWCREST ST, SUITE 204, GRETNA, LA 70056-5257
(504) 392-4734
Mailing address
250 MEADOWCREST ST, SUITE 204, GRETNA, LA 70056-5257
(504) 392-4734
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3436
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1834360
—
LA
Enumeration date
03/22/2007
Last updated
07/09/2007
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