Provider Demographics
NPI:1952485757
Name:PLATT, SHEP (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEP
Middle Name:
Last Name:PLATT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:WALTER
Other - Middle Name:S
Other - Last Name:PLATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:6535 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4259
Mailing Address - Country:US
Mailing Address - Phone:225-761-8585
Mailing Address - Fax:225-761-1979
Practice Address - Street 1:6535 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4259
Practice Address - Country:US
Practice Address - Phone:225-761-8585
Practice Address - Fax:225-761-1979
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA30171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice