Organization
MAXILLOFACIAL IMAGING OF BATON ROUGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J RICHARDSON DDS (PRESIDENT)
(225) 218-0225
Entity
Organization
Contact information
Practice address
7967 OFFICE PARK BLVD, BATON ROUGE, LA 70809-7646
(225) 218-0225
Mailing address
7967 OFFICE PARK BLVD, BATON ROUGE, LA 70809-7646
(225) 218-0225
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3462
LA
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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