Individual
DR. CHAD MARTIN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
268 HARRINGTON AVE, BASTROP, LA 71220-3026
(318) 281-5972
(318) 281-9964
Mailing address
268 HARRINGTON AVE, BASTROP, LA 71220-3026
(318) 281-5972
(318) 281-9964
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5638
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1856380
—
LA
Enumeration date
09/26/2006
Last updated
07/08/2007
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