Provider Demographics
NPI:1689143083
Name:EDDLEMAN CRIGLER DENTAL PLLC
Entity Type:Organization
Organization Name:EDDLEMAN CRIGLER DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ACACIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ACCARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-322-2013
Mailing Address - Street 1:2511 BROADMOOR BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2987
Mailing Address - Country:US
Mailing Address - Phone:318-322-2013
Mailing Address - Fax:318-322-2048
Practice Address - Street 1:2511 BROADMOOR BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2987
Practice Address - Country:US
Practice Address - Phone:318-322-2013
Practice Address - Fax:318-322-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty