Provider Demographics
NPI:1548384787
Name:DICKERSON, ARTHUR WELDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:WELDON
Last Name:DICKERSON
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 1:2438 OCTAVIA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6534
Mailing Address - Country:US
Mailing Address - Phone:504-862-5853
Mailing Address - Fax:
Practice Address - Street 1:250 MEADOWCREST ST
Practice Address - Street 2:STE 200
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5257
Practice Address - Country:US
Practice Address - Phone:504-391-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA30741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics