Provider Demographics
NPI:1033187687
Name:DUGAS, RANDY P (DDS)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:P
Last Name:DUGAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 OLD JEANERETTE RD.
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563
Mailing Address - Country:US
Mailing Address - Phone:337-365-0816
Mailing Address - Fax:337-365-9796
Practice Address - Street 1:2217 OLD JEANERETTE RD.
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563
Practice Address - Country:US
Practice Address - Phone:337-365-0816
Practice Address - Fax:337-365-9796
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA32751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice