Provider Demographics
NPI:1275672180
Name:BIRRIEL, JANE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:M
Last Name:BIRRIEL
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:PO BOX 3433
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70381-3433
Mailing Address - Country:US
Mailing Address - Phone:985-385-2992
Mailing Address - Fax:985-385-2994
Practice Address - Street 1:1151 MARGUERITE ST
Practice Address - Street 2:SUITE 100A
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1850
Practice Address - Country:US
Practice Address - Phone:985-385-2992
Practice Address - Fax:985-385-2994
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA 4764122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist