Organization
SANDERS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL HART SANDERS DDS (OWNER)
(985) 876-5430
Entity
Organization
Contact information
Practice address
761 W TUNNEL BLVD, SUITE A, HOUMA, LA 70360-5545
(985) 876-5430
(985) 876-0455
Mailing address
761 W TUNNEL BLVD, SUITE A, HOUMA, LA 70360-5545
(985) 876-5430
(985) 876-0455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4648
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1846481
—
LA
Enumeration date
08/06/2009
Last updated
08/06/2009
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