Provider Demographics
NPI:1760754709
Name:ADH-METAIRIE LLC
Entity Type:Organization
Organization Name:ADH-METAIRIE LLC
Other - Org Name:METAIRIE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:SUADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-753-5885
Mailing Address - Street 1:15420 S HARRELLS FERRY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2933
Mailing Address - Country:US
Mailing Address - Phone:225-753-5885
Mailing Address - Fax:
Practice Address - Street 1:3401 W. ESPLANADE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:225-753-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA48181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty