Provider Demographics
NPI:1033733746
Name:MICHAEL P JUBAN DDS AND J CODY COWEN NORTH APDLLC
Entity Type:Organization
Organization Name:MICHAEL P JUBAN DDS AND J CODY COWEN NORTH APDLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-927-8663
Mailing Address - Street 1:8564 JEFFERSON HWY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2424
Mailing Address - Country:US
Mailing Address - Phone:225-927-8663
Mailing Address - Fax:
Practice Address - Street 1:8670 AIRLINE HIGHWAY
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815
Practice Address - Country:US
Practice Address - Phone:225-927-8968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty