Provider Demographics
NPI:1134279300
Name:RICHARD, GIZELLE POCHE' (DDS)
Entity Type:Individual
Prefix:MRS
First Name:GIZELLE
Middle Name:POCHE'
Last Name:RICHARD
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 1:4460 GENERAL DEGAULLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-6916
Mailing Address - Country:US
Mailing Address - Phone:504-394-5330
Mailing Address - Fax:504-394-5556
Practice Address - Street 1:4460 GENERAL DEGAULLE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-6916
Practice Address - Country:US
Practice Address - Phone:504-394-5330
Practice Address - Fax:504-394-5556
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice