Organization
PHILLIP L STELLY DDS
Active
Other names
Phillip L Stelly DDS A Professionel Dental Corp
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP L STELLY DDS (OWNER DENTIST)
(337) 896-3267
Entity
Organization
Contact information
Practice address
258 ARCENEAUX RD, CARENCRO, LA 70520
(337) 896-9132
(337) 896-7852
Mailing address
258 ARCENEAUX RD, CARENCRO, LA 70520
(337) 896-3267
(337) 896-7852
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4453
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1844535
—
LA
Enumeration date
03/27/2007
Last updated
10/01/2007
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