Provider First Line Business Practice Location Address:
1100 FLORIDA AVE, BOX 220
Provider Second Line Business Practice Location Address:
LSU SCHOOL OF DENTISTRY
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70119-2799
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-941-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2011