Provider Demographics
NPI:1235434002
Name:LISA P. GERMAIN D.D.S., M.SC.D., L.L.C.
Entity Type:Organization
Organization Name:LISA P. GERMAIN D.D.S., M.SC.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:P
Authorized Official - Last Name:GERMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSCD
Authorized Official - Phone:504-895-1100
Mailing Address - Street 1:2633 NAPOLEON AVE STE 701
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-7416
Mailing Address - Country:US
Mailing Address - Phone:504-895-1100
Mailing Address - Fax:504-895-1177
Practice Address - Street 1:2633 NAPOLEON AVE STE 701
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-7416
Practice Address - Country:US
Practice Address - Phone:504-895-1100
Practice Address - Fax:504-895-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39591223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty