Provider Demographics
NPI:1598893091
Name:STACIE L NOE, DDS, APDC
Entity Type:Organization
Organization Name:STACIE L NOE, DDS, APDC
Other - Org Name:DENTAL CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST-CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NOE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-542-3368
Mailing Address - Street 1:212 W MINNESOTA PARK RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6125
Mailing Address - Country:US
Mailing Address - Phone:985-542-3368
Mailing Address - Fax:985-543-3335
Practice Address - Street 1:212 W MINNESOTA PARK RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6125
Practice Address - Country:US
Practice Address - Phone:985-542-3368
Practice Address - Fax:985-543-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1880981Medicaid