Organization
TYLER R MESA PEDIATRIC DENTISTRY
Active
Other names
Live Oak Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER MESA DDS (OWNER/PEDIATRIC DENTIST)
(985) 705-8144
Entity
Organization
Contact information
Practice address
2800 GAUSE BLVD E STE D, SLIDELL, LA 70461-4247
(985) 259-6737
Mailing address
2800 GAUSE BLVD E STE D, SLIDELL, LA 70461-4247
(985) 259-6737
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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