Provider Demographics
NPI:1477998318
Name:GUIDRY, PATRICK (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:GUIDRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24021 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3350
Mailing Address - Country:US
Mailing Address - Phone:225-687-4892
Mailing Address - Fax:225-687-4894
Practice Address - Street 1:24021 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3350
Practice Address - Country:US
Practice Address - Phone:225-687-4892
Practice Address - Fax:225-687-4894
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice