Provider Demographics
NPI:1326285362
Name:DRAGON, NOEL PETER JR (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:PETER
Last Name:DRAGON
Suffix:JR
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:518 W FARREL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7054
Mailing Address - Country:US
Mailing Address - Phone:337-412-6281
Mailing Address - Fax:337-412-6294
Practice Address - Street 1:301 RUE BEAUREGARD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8520
Practice Address - Country:US
Practice Address - Phone:337-412-6281
Practice Address - Fax:337-412-6294
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA24371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics