Provider Demographics
NPI:1013367879
Name:TODD J. CANATELLA, JR. APDC
Entity Type:Organization
Organization Name:TODD J. CANATELLA, JR. APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:CANATELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-282-0700
Mailing Address - Street 1:101 W ROBERT E LEE BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2473
Mailing Address - Country:US
Mailing Address - Phone:504-282-0700
Mailing Address - Fax:
Practice Address - Street 1:101 W ROBERT E LEE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-2473
Practice Address - Country:US
Practice Address - Phone:504-282-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6649122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty