Individual
DR. ROBERT BURTON BODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1144 COOLIDGE BLVD STE A, LAFAYETTE, LA 70503-2622
(337) 234-8788
(337) 234-8723
Mailing address
1144 COOLIDGE BLVD STE A, LAFAYETTE, LA 70503-2622
(337) 234-8788
(337) 234-8723
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3375
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1833754
—
LA
Enumeration date
07/10/2006
Last updated
07/09/2007
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