Provider Demographics
NPI:1780814590
Name:MANUEL, CAROLINE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:M
Last Name:MANUEL
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 1:118 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-4608
Mailing Address - Country:US
Mailing Address - Phone:337-457-4007
Mailing Address - Fax:337-457-4077
Practice Address - Street 1:118 S 2ND ST
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-4608
Practice Address - Country:US
Practice Address - Phone:337-457-4007
Practice Address - Fax:337-457-4077
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA58451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics