Individual
DR. CARLITO P. ILAWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
400 MYRTLE DR, COVINGTON, LA 70433-8149
(985) 892-2711
(985) 892-7669
Mailing address
400 MYRTLE DR, COVINGTON, LA 70433-8149
(985) 892-2711
(985) 892-7669
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4361
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660199
—
MS
05
—
1843610
—
LA
01
—
971021
UNITED CONCORDIA
PA
01
—
A2370
BLUE CROSS BLUE SHIELD OF LA
LA
Enumeration date
05/14/2008
Last updated
09/11/2025
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