Individual
DR. JASON ROBERT ALVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2881 HIGHWAY 190 STE D4, MANDEVILLE, LA 70471-3248
(985) 626-8980
(985) 727-4660
Mailing address
2881 HIGHWAY 190 STE D4, MANDEVILLE, LA 70471-3248
(985) 626-8980
(985) 727-4660
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6261
LA
1223G0001X
General Practice Dentistry
6261
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2852582
—
LA
Enumeration date
05/21/2012
Last updated
07/21/2022
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