Provider Demographics
NPI:1821527888
Name:DUPLANTIER, MARTIN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:JOSEPH
Last Name:DUPLANTIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 PLEASURE LN
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3736
Mailing Address - Country:US
Mailing Address - Phone:404-754-3307
Mailing Address - Fax:
Practice Address - Street 1:1608 POLK ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-6011
Practice Address - Country:US
Practice Address - Phone:985-879-1972
Practice Address - Fax:985-879-4661
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2022-10-12
Deactivation Date:2022-09-26
Deactivation Code:
Reactivation Date:2022-10-05
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA68041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program