Provider Demographics
NPI:1578185096
Name:DR. RAYMOND POIRRIER DDS LLC
Entity Type:Organization
Organization Name:DR. RAYMOND POIRRIER DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:POIRRIER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-319-2265
Mailing Address - Street 1:1438 JOEL DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-5708
Mailing Address - Country:US
Mailing Address - Phone:504-319-2265
Mailing Address - Fax:985-900-2332
Practice Address - Street 1:1968 N HIGHWAY 190 STE 11A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5158
Practice Address - Country:US
Practice Address - Phone:985-400-5888
Practice Address - Fax:985-900-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental