Provider Demographics
NPI:1497866719
Name:DENTAL PLUS, LLC
Entity Type:Organization
Organization Name:DENTAL PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-463-6545
Mailing Address - Street 1:1808 HIGHWAY 190 W
Mailing Address - Street 2:SUITE D
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-6023
Mailing Address - Country:US
Mailing Address - Phone:337-463-6545
Mailing Address - Fax:337-460-1966
Practice Address - Street 1:1808 HIGHWAY 190 W
Practice Address - Street 2:SUITE D
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-6023
Practice Address - Country:US
Practice Address - Phone:337-463-6545
Practice Address - Fax:337-460-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52361223E0200X
LA29871223G0001X
LA46631223G0001X
LA44211223G0001X
LA51701223G0001X
LA49501223G0001X
LA54491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty