Chad M Gardner Dds A Professional Dental Corporation

NPI 1124395389 - Dentist - 122300000X

NPI Details
NPI 1124395389
Enumeration Date 11/16/2011
Last Updated 11/16/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name CHAD MARTIN CHAD
Position OWNER/DENTIST
Phone (318) 281-5972
Fax (318) 281-9964
Practice Location
625 S WASHINGTON ST
BASTROP LA, 71220-5034, US
Phone (318) 281-5972
Fax (318) 281-9964
Business Location
625 S WASHINGTON ST
BASTROP LA, 71220-5034, US
Phone (318) 281-5972
Fax (318) 281-9964
Toxanomy
Taxonomy Code 122300000X
License State Louisiana
License Number 5638
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According to our database, Chad M Gardner Dds A Professional Dental Corporation NPI is 1124395389, taxonomy code is 122300000X and license number is 5638, license state is located at Louisiana. Chad M Gardner Dds A Professional Dental Corporation physically located at 625 S Washington St, Bastrop LA, 71220-5034. NPI Number 1033115704 has the healthcare provider type.

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1124395389 NPI number is provided on an as is basis without warranty of any kind. 1124395389 is maintained by the National Plan & Provider Enumeration System. The contents of Chad M Gardner Dds A Professional Dental Corporation are for informational purposes only.