Organization
PAMELA DAIGLE DDS LLC
Active
Other names
Off The Trace Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA PONCE DE LEON DAIGLE DDS (OWNER/MANAGER)
(985) 326-1711
Entity
Organization
Contact information
Practice address
2130 GAUSE BLVD W, SLIDELL, LA 70460-4118
(985) 326-1711
Mailing address
1 SAINT ANN DR # 8645, MANDEVILLE, LA 70471-3204
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2022
Last updated
03/12/2022
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