Provider Demographics
NPI:1851912711
Name:COVINGTON EMPOWER ORTHODONTICS LLC - DR TIMOTHY M POYADOU JR
Entity Type:Organization
Organization Name:COVINGTON EMPOWER ORTHODONTICS LLC - DR TIMOTHY M POYADOU JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:POYADOU
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-888-1500
Mailing Address - Street 1:100 TYLER SQ STE 4
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3060
Mailing Address - Country:US
Mailing Address - Phone:985-888-1500
Mailing Address - Fax:
Practice Address - Street 1:100 TYLER SQ STE 4
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3060
Practice Address - Country:US
Practice Address - Phone:985-888-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental