Provider Demographics
NPI:1821359175
Name:TONY SOILEAU,DDS LLC
Entity Type:Organization
Organization Name:TONY SOILEAU,DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOILEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-234-3551
Mailing Address - Street 1:420 SETTLERS TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6047
Mailing Address - Country:US
Mailing Address - Phone:337-234-3551
Mailing Address - Fax:
Practice Address - Street 1:420 SETTLERS TRACE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6047
Practice Address - Country:US
Practice Address - Phone:337-234-3551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4815122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty