Individual
MR. WAYNE HOLDEN MARIONNEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
192 BURT BLVD, BENTONE, LA 71006
(318) 965-2424
(318) 965-0943
Mailing address
PO BOX 427, 192 BURT BLVD, BENTON, LA 71006-0427
(318) 965-2424
(318) 965-0943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3571
LA
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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