Provider Demographics
NPI:1659876134
Name:LULING FAMILY DENTISTRY, LLC
Entity Type:Organization
Organization Name:LULING FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:CEFALU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-785-6011
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-0167
Mailing Address - Country:US
Mailing Address - Phone:985-785-6011
Mailing Address - Fax:985-785-6082
Practice Address - Street 1:207 5TH STREET
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-0167
Practice Address - Country:US
Practice Address - Phone:985-785-6011
Practice Address - Fax:985-785-6082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty