Organization
ASCENSION ORAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK RICHARD JOSEPHS DMD (ORAL AND MAXILLOFACIAL SURGEON)
(225) 744-2660
Entity
Organization
Contact information
Practice address
16260 AIRLINE HWY, SUITE A, PRAIRIEVILLE, LA 70769-4272
(225) 744-2660
(225) 744-2666
Mailing address
16260 AIRLINE HWY, SUITE A, PRAIRIEVILLE, LA 70769-4272
(225) 744-2660
(225) 744-2666
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6296
LA
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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