Provider Demographics
NPI:1659457091
Name:FLEUR DE LIS DENTAL CARE
Entity Type:Organization
Organization Name:FLEUR DE LIS DENTAL CARE
Other - Org Name:JORGE M. AGUILAR, DDS AND JON D. CELINO, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:D
Authorized Official - Last Name:CELINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-486-3339
Mailing Address - Street 1:6000 FLEUR DE LIS DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1246
Mailing Address - Country:US
Mailing Address - Phone:504-486-3339
Mailing Address - Fax:888-562-2863
Practice Address - Street 1:6000 FLEUR DE LIS DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-1246
Practice Address - Country:US
Practice Address - Phone:504-486-3339
Practice Address - Fax:888-562-2863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty