Provider Demographics
NPI:1639508302
Name:JOSHUA K. GIROD, DDS, LLC
Entity Type:Organization
Organization Name:JOSHUA K. GIROD, DDS, LLC
Other - Org Name:GONZALES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:GIROD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-644-2183
Mailing Address - Street 1:17398 E AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769
Mailing Address - Country:US
Mailing Address - Phone:225-938-9639
Mailing Address - Fax:
Practice Address - Street 1:318 E CORNERVIEW
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737
Practice Address - Country:US
Practice Address - Phone:225-644-2183
Practice Address - Fax:225-647-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6194261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental