Provider First Line Business Practice Location Address:
1100 FLORIDA AVENUE LSUHSC SCHOOL OF DENTISTRY
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PERIODONTICS, 4TH FLOOR
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-941-8278
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2013