Provider Demographics
NPI:1023110079
Name:RABALAIS, MURRAY LUKE JR (PD, DDS)
Entity type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:LUKE
Last Name:RABALAIS
Suffix:JR
Gender:M
Credentials:PD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 PROGRESSIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4024
Mailing Address - Country:US
Mailing Address - Phone:985-872-2215
Mailing Address - Fax:985-580-4020
Practice Address - Street 1:236 PROGRESSIVE BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4024
Practice Address - Country:US
Practice Address - Phone:985-872-2215
Practice Address - Fax:985-580-4020
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA23761223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics