Provider Demographics
NPI:1508174186
Name:HESS, ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALICE
Other - Middle Name:ELIZABETH
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1215 INDEPENDENCE BLVD
Mailing Address - Street 2:BUILDING 1, SUITE B
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-7387
Mailing Address - Country:US
Mailing Address - Phone:225-570-8808
Mailing Address - Fax:
Practice Address - Street 1:1215 INDEPENDENCE BLVD
Practice Address - Street 2:BUILDING 1, SUITE B
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7387
Practice Address - Country:US
Practice Address - Phone:225-570-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA60911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics