Organization · Type 2 NPI
Nathan Ray Fontenot, Jr., Apdc
Dental Clinic/Center · Jennings, LA
NPI number
1114262649
Active
Practice location
715 N Main St
Jennings, LA 70546-5311
Fax (337) 824-4961
Mailing address
PO Box 815
Jennings, LA 70546-0815
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 3543 (LA) |
Dental Clinic/Center: Definition to come...
About NPI 1114262649
Nathan Ray Fontenot, Jr., Apdc's National Provider Identifier is 1114262649, issued on Dec 10, 2012. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Jennings, LA. The record was last updated on Dec 10, 2012.