Provider Demographics
NPI:1316011760
Name:ENDODONTIC ASSOCIATES LLC
Entity Type:Organization
Organization Name:ENDODONTIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:504-391-2324
Mailing Address - Street 1:250 MEADOWCREST ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-5257
Mailing Address - Country:US
Mailing Address - Phone:504-391-2324
Mailing Address - Fax:
Practice Address - Street 1:250 MEADOWCREST ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5257
Practice Address - Country:US
Practice Address - Phone:504-391-2324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACPE 35544536K1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty