Individual
DR. BRETT DAVID MADERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
190 CENTRAL AVE, P.O. DRAWER O, RESERVE, LA 70084-6000
(985) 536-3193
Mailing address
190 CENTRAL AVE, P.O. DRAWER O, RESERVE, LA 70084
(985) 536-3193
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4435
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235264367
CORPORATE NPI
LA
Enumeration date
05/24/2013
Last updated
05/24/2013
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