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Organization

DLS OF ALEXANDRIA

Active
Parent organization
DLS OF ALEXANDRIA
Other names
John C Moreau Jr DDS
Organization subpart
Yes

Provider details

NPI number
Legal business name
DLS OF ALEXANDRIA
Authorized official
JOHN C MOREAU JR. DDS (OWNER)
(318) 442-9555
Entity
Organization

Contact information

Practice address
3820 MASONIC DR, ALEXANDRIA, LA 71301-3628
(318) 442-9555
(318) 442-0475
Mailing address
3820 MASONIC DR, ALEXANDRIA, LA 71301-3628
(318) 442-9555
(318) 442-0475

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3992
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1839922
LA
Enumeration date
03/03/2016
Last updated
03/03/2016
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