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Organization

NORTHLAKE ORAL AND FACIAL SURGERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NATHAN RIAS BROWN MD, DMD (SOLE MEMBER)
(985) 643-1010
Entity
Organization

Contact information

Practice address
1271 7TH ST, SLIDELL, LA 70458-2041
(985) 643-1010
Mailing address
1271 7TH ST, SLIDELL, LA 70458-2041
(985) 643-1010

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6298
LA

Other

Enumeration date
10/01/2012
Last updated
11/02/2012
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