Provider Demographics
NPI:1184636839
Name:PRATT, CLAUDE S (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:S
Last Name:PRATT
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 1:422 DURHAM ST
Mailing Address - Street 2:8517 OLD MONROE ROAD
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-5067
Mailing Address - Country:US
Mailing Address - Phone:318-281-2188
Mailing Address - Fax:
Practice Address - Street 1:422 DURHAM ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-5067
Practice Address - Country:US
Practice Address - Phone:318-281-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2375122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1823759Medicaid