Provider Demographics
NPI:1619192762
Name:LAVESPERE, JAMES ERIC (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ERIC
Last Name:LAVESPERE
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 1:2800 KILPATRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5139
Mailing Address - Country:US
Mailing Address - Phone:318-855-5021
Mailing Address - Fax:318-855-5025
Practice Address - Street 1:2800 KILPATRICK BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5139
Practice Address - Country:US
Practice Address - Phone:318-855-5021
Practice Address - Fax:318-855-5025
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics