Individual
DR. CHARLES CARY MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1008 SMEDE HWY, SUITE E, BROUSSARD, LA 70518-8036
(337) 359-8705
Mailing address
102 BALTUSROL DR, BROUSSARD, LA 70518-6129
(337) 359-8705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA-5044
LA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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