Gantt Nicholson Dejean DDS MS

NPI 1083752422 - Dentist - 1223P0221X

NPI Details
NPI 1083752422
Gender Male
Enumeration Date 02/01/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1604 KERR ST
SUITE 101
OPELOUSAS LA, 70570, US
Phone (337) 948-8253
Fax (337) 942-8161
Business Location
1604 KERR ST
SUITE 101
OPELOUSAS LA, 70570, US
Phone (337) 948-8253
Fax (337) 942-8161
Toxanomy
Taxonomy Code 1223P0221X
License State Louisiana
License Number 2435
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According to our database, Gantt Nicholson Dejean DDS MS NPI is 1083752422, taxonomy code is 1223P0221X and license number is 2435, license state is located at Louisiana. Gantt Nicholson Dejean DDS MS physically located at 1604 Kerr St, Opelousas LA, 70570. NPI Number Gantt Nicholson Dejean DDS MS has the Individual type.

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1083752422 NPI number is provided on an as is basis without warranty of any kind. 1083752422 is maintained by the National Plan & Provider Enumeration System. The contents of Gantt Nicholson Dejean DDS MS are for informational purposes only.