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Organization

WYATT DENTAL GROUP, LLC

Active
Parent organization
LISA WYATT, D.D.S.
Organization subpart
Yes

Provider details

NPI number
Legal business name
LISA WYATT, D.D.S.
Authorized official
DR. LISA WYATT DDS (OWNER/DENTIST)
(504) 885-1039
Entity
Organization

Contact information

Practice address
5037 VETERANS MEMORIAL BLVD, STE 3E, METAIRIE, LA 70006-5136
(504) 885-1039
(504) 885-2028
Mailing address
5037 VETERANS MEMORIAL BLVD, STE 3E, METAIRIE, LA 70006
(504) 885-1039
(504) 885-2028

Taxonomy

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

Other

Enumeration date
04/22/2010
Last updated
04/22/2010
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