Organization
EDMOND J. GANUCHEAU, JR. DDS, APDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYON C GANUCHEAU DDS (PRESIDENT)
(504) 887-3121
Entity
Organization
Contact information
Practice address
2825 HOUMA BLVD, METAIRIE, LA 70006-6635
(504) 887-3121
Mailing address
2825 HOUMA BLVD, METAIRIE, LA 70006-6635
(504) 887-3121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4959
LA
1223G0001X
General Practice Dentistry
5403
LA
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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