Provider Demographics
NPI:1275108235
Name:DAIGLE, JULIA ELYSE (DDS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ELYSE
Last Name:DAIGLE
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 1:147 JESUIT BEND DR
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-4165
Mailing Address - Country:US
Mailing Address - Phone:504-722-2326
Mailing Address - Fax:
Practice Address - Street 1:2937 VETERANS MEMORIAL BLVD STE C
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6067
Practice Address - Country:US
Practice Address - Phone:504-206-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-23
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice