Organization
ST. BERNARD DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY MANUEL CREAR D.D.S. (OWNER)
(504) 392-9874
Entity
Organization
Contact information
Practice address
2600 BELLE CHASSE HWY STE 200, TERRYTOWN, LA 70056-7156
(504) 392-9874
(504) 392-9990
Mailing address
2600 BELLE CHASSE HWY STE 200, TERRYTOWN, LA 70056-7156
(504) 392-9874
(504) 392-9990
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1880311
—
LA
Enumeration date
02/23/2007
Last updated
08/22/2020
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