Provider Demographics
NPI:1821305822
Name:GENERAL MEYER FAMILY DENTAL
Entity Type:Organization
Organization Name:GENERAL MEYER FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SIMIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-365-5573
Mailing Address - Street 1:3201 GENERAL MEYER AVE STE B
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-3201
Mailing Address - Country:US
Mailing Address - Phone:504-365-5573
Mailing Address - Fax:504-365-0922
Practice Address - Street 1:3201 GENERAL MEYER AVE STE B
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-3201
Practice Address - Country:US
Practice Address - Phone:504-365-5573
Practice Address - Fax:504-365-0922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-12
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA54451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty