Provider Demographics
NPI:1831287531
Name:MOREAU, JAMES A JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:MOREAU
Suffix:JR
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 1:7007 HIGHWAY 190 EAST SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4955
Mailing Address - Country:US
Mailing Address - Phone:985-809-7645
Mailing Address - Fax:985-893-2485
Practice Address - Street 1:7007 HIGHWAY 190 EAST SERVICE RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4955
Practice Address - Country:US
Practice Address - Phone:985-809-7645
Practice Address - Fax:985-893-2485
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA34411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice