Provider Demographics
NPI:1780181180
Name:BEGUE, AMANDA HALL (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:HALL
Last Name:BEGUE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7063 ARGONNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-4001
Mailing Address - Country:US
Mailing Address - Phone:828-713-0804
Mailing Address - Fax:
Practice Address - Street 1:159 LONGVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-5076
Practice Address - Country:US
Practice Address - Phone:985-307-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA66851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty