Organization
ANTHONY INDOVINA A P D C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY A. INDOVINA SR. D.D.S. (OWNER/PRESIDENT)
(504) 340-2401
Entity
Organization
Contact information
Practice address
5132 LAPALCO BLVD, 2ND FLOOR, MARRERO, LA 70072-4268
(504) 340-2401
(504) 340-2423
Mailing address
5132 LAPALCO BLVD, 2ND FLOOR, MARRERO, LA 70072-4268
(504) 340-2401
(504) 340-2423
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2650
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1826502
—
LA
01
—
600034
UNITED CONCORDIA
LA
Enumeration date
02/09/2011
Last updated
02/09/2011
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