Provider Demographics
NPI:1033365606
Name:LESTER, DANIEL GODDARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GODDARD
Last Name:LESTER
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 1:1431 PETERMAN DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3433
Mailing Address - Country:US
Mailing Address - Phone:318-443-5013
Mailing Address - Fax:
Practice Address - Street 1:1431 PETERMAN DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3433
Practice Address - Country:US
Practice Address - Phone:318-443-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA56491223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics