Individual
DR. LISA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.,B.S.,D.D.S.
Contact information
Practice address
5037 VETERANS BLVD, SUITE 3E, METAIRIE, LA 70006
(504) 885-1039
(504) 885-2028
Mailing address
5037 VETERANS BLVD, SUITE 3E, METAIRIE, LA 70006
(504) 885-1039
(504) 885-2028
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4831
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1848310
—
LA
Enumeration date
12/29/2006
Last updated
07/08/2007
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