Individual
MR. IAN FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
200 HECTOR CONNOLY RD STE 102, CARENCRO, LA 70520-6348
(337) 565-2580
(337) 565-2799
Mailing address
200 HECTOR CONNOLY RD STE 102, CARENCRO, LA 70520-6348
(337) 565-2580
(337) 565-2799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5988
LA
Other
Enumeration date
05/04/2010
Last updated
06/09/2014
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