Provider Demographics
NPI:1699195180
Name:CONCEPTS IN DENTISTRY SHANE M ZERINGUE DDS LLC
Entity Type:Organization
Organization Name:CONCEPTS IN DENTISTRY SHANE M ZERINGUE DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARMANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-851-7905
Mailing Address - Street 1:855 BELANGER ST STE 211
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4463
Mailing Address - Country:US
Mailing Address - Phone:985-851-7905
Mailing Address - Fax:
Practice Address - Street 1:855 BELANGER ST STE 211
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4463
Practice Address - Country:US
Practice Address - Phone:985-851-7905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA53601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty