Provider Demographics
NPI:1073111415
Name:BRINDIS PROSTHODONTICS, LLC
Entity Type:Organization
Organization Name:BRINDIS PROSTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:BRINDIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-883-3737
Mailing Address - Street 1:4228 HOUMA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-3005
Mailing Address - Country:US
Mailing Address - Phone:504-883-3737
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3005
Practice Address - Country:US
Practice Address - Phone:504-883-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty