Provider Demographics
NPI:1942401757
Name:DENTAL PLUS LLC
Entity Type:Organization
Organization Name:DENTAL PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3374-636-5456
Mailing Address - Street 1:706 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4719
Mailing Address - Country:US
Mailing Address - Phone:337-238-2631
Mailing Address - Fax:337-238-0801
Practice Address - Street 1:706 S 6TH ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4719
Practice Address - Country:US
Practice Address - Phone:337-238-2631
Practice Address - Fax:337-238-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA29871223G0001X
LA46631223G0001X
LA44211223G0001X
LA51701223G0001X
LA49501223G0001X
LA29661223G0001X
LA54491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty