Provider Demographics
NPI:1598824674
Name:ST CLAUDE GENTLE DENTAL CENTER INC
Entity Type:Organization
Organization Name:ST CLAUDE GENTLE DENTAL CENTER INC
Other - Org Name:LOUISIANA DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:LACOSTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-345-0240
Mailing Address - Street 1:305 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401
Mailing Address - Country:US
Mailing Address - Phone:985-345-0240
Mailing Address - Fax:985-345-0250
Practice Address - Street 1:4232 ST CLAUDE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117
Practice Address - Country:US
Practice Address - Phone:504-947-2958
Practice Address - Fax:504-947-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental