Provider Demographics
NPI:1043330145
Name:MAES, WENDY M (DDS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:MAES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 LAPALCO BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2302
Mailing Address - Country:US
Mailing Address - Phone:504-347-6000
Mailing Address - Fax:504-340-0186
Practice Address - Street 1:3909 LAPALCO BLVD STE 202
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2302
Practice Address - Country:US
Practice Address - Phone:504-347-6000
Practice Address - Fax:504-340-0186
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice