Provider Demographics
NPI:1477620664
Name:BEHRENDS, ANN MARGUERITE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARGUERITE
Last Name:BEHRENDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:MARGUERITE
Other - Last Name:BEHRENDS-JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7223 MISSISSIPPI AVE.
Mailing Address - Street 2:
Mailing Address - City:FORT POLK
Mailing Address - State:LA
Mailing Address - Zip Code:71459
Mailing Address - Country:US
Mailing Address - Phone:337-531-2327
Mailing Address - Fax:
Practice Address - Street 1:7223 MISSISSIPPI AVE.
Practice Address - Street 2:BLDG 1561
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459
Practice Address - Country:US
Practice Address - Phone:337-532-2327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16951122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist