Canal St Family Dentistry | |
2752 Canal St New Orleans LA 70119-5502 | |
(504) 482-5444 | |
(504) 486-0482 |
Full Name | Canal St Family Dentistry |
---|---|
Speciality | Dentist |
Location | 2752 Canal St, New Orleans, Louisiana |
Authorized Official Name and Position | Rayfield Lotten (DENTIST/OWNER) |
Authorized Official Contact | 5044825444 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Canal St Family Dentistry 2752 Canal St New Orleans LA 70119-5502 Ph: (504) 482-5444 | Canal St Family Dentistry 2752 Canal St New Orleans LA 70119-5502 Ph: (504) 482-5444 |
NPI Number | 1255637005 |
---|---|
Provider Enumeration Date | 01/26/2011 |
Last Update Date | 01/26/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255637005 | NPI | - | NPPES |
1850420 | Medicaid | LA | |
1857068 | Medicaid | LA | |
1860115 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 5042 (Louisiana) | Primary |
122300000X | Dentist | 6011 (Louisiana) | Secondary |
122300000X | Dentist | 5706 (Louisiana) | Secondary |
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› Verified 5 days ago
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