Provider Demographics
NPI:1528583945
Name:BATON ROUGE PERIO, L.L.C.
Entity Type:Organization
Organization Name:BATON ROUGE PERIO, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:FORD
Authorized Official - Last Name:MARKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-769-1444
Mailing Address - Street 1:10723 N. OAK HILLS PARKWAY, BLDG. B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810
Mailing Address - Country:US
Mailing Address - Phone:225-769-1444
Mailing Address - Fax:225-769-9939
Practice Address - Street 1:10723 N. OAK HILLS PARKWAY, BLDG. B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810
Practice Address - Country:US
Practice Address - Phone:225-769-1444
Practice Address - Fax:225-769-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty