Organization
HENAGAN TEAM DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE P THOMPSON (FINANCIAL/INSURANCE COORDINATOR)
(337) 364-2156
Entity
Organization
Contact information
Practice address
600 RUE DE LION, NEW IBERIA, LA 70563-2113
(337) 364-2156
(337) 364-7875
Mailing address
600 RUE DE LION, NEW IBERIA, LA 70563-2113
(337) 364-2156
(337) 364-7875
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C1334
BCBS PROVIDER NO.
LA
Enumeration date
06/11/2019
Last updated
06/11/2019
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