Nathan Ray Fontenot, Jr., Apdc
Dental Clinic/Center in Jennings, LA(View on Map)
Legal Business Name
Nathan Ray Fontenot, Jr., Apdc
NPI Number
1114262649
NPI Type
Organization
Enumeration Date
12/10/2012
Specialties
(Taxonomies)Licenses
State
Louisiana
License Number
3543
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 815
715 N MAIN ST
City
Jennings
Jennings
State
LA
LA
Postal Code
70546-0815
70546-5311
Country
US
US
Telephone Number
(337) 824-4963
(337) 824-4963
Authorized Official
Name
Dr. Nathan Fontenot
Title or Position
OWNER/DENTIST
Telephone Number
(337) 824-4963
Identifiers
Identifier
18354319
Identifier State
LA
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/10/2012