Country Club Dental

NPI 1003970682 - Dentist - 1223G0001X

NPI Details
NPI 1003970682
Enumeration Date 12/20/2006
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DARRELL PAUL DARRELL
Position DENTIST
Phone (225) 214-0100
Fax (225) 214-0103
Practice Location
16645 HIGHLAND RD STE J
BATON ROUGE LA, 70810-6567, US
Phone (225) 214-0100
Fax (225) 214-0103
Business Location
16645 HIGHLAND RD STE J
BATON ROUGE LA, 70810-6567, US
Phone (225) 214-0100
Fax (225) 214-0103
Toxanomy
Taxonomy Code 1223G0001X
License State Louisiana
License Number 5312
Remove 1003970682 NPI Number
 

According to our database, Country Club Dental NPI is 1003970682, taxonomy code is 1223G0001X and license number is 5312, license state is located at Louisiana. Country Club Dental physically located at 16645 Highland Rd Ste J, Baton Rouge LA, 70810-6567. NPI Number 1033115704 has the healthcare provider type.

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1003970682 NPI number is provided on an as is basis without warranty of any kind. 1003970682 is maintained by the National Plan & Provider Enumeration System. The contents of Country Club Dental are for informational purposes only.