Individual
DR. DOUGLAS M GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
430 E PINE ST, PONCHATOULA, LA 70454-2544
(985) 386-8454
(985) 386-8467
Mailing address
430 E PINE ST, PONCHATOULA, LA 70454-2544
(985) 386-8454
(985) 386-8467
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6849
LA
1223G0001X
General Practice Dentistry
Primary
6849
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Enumeration date
04/25/2018
Last updated
05/27/2021
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