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Individual

DR. MARTHA JENNILEE NOLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5454 CYPRESS ST, WEST MONROE, LA 71291-7508
(318) 396-0054
(318) 397-0850
Mailing address
5454 CYPRESS ST, WEST MONROE, LA 71291-7508
(318) 396-0054
(318) 397-0850

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6262
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1862622
LA
Enumeration date
06/11/2012
Last updated
11/05/2024
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