Provider Demographics
NPI:1205193117
Name:OWENS, SEAN CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:CHRISTOPHER
Last Name:OWENS
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 1:1020 DAISY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT GABRIEL
Mailing Address - State:LA
Mailing Address - Zip Code:70776-5127
Mailing Address - Country:US
Mailing Address - Phone:225-241-9068
Mailing Address - Fax:
Practice Address - Street 1:40470 GERMANY RD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-6735
Practice Address - Country:US
Practice Address - Phone:225-622-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice