Provider Demographics
NPI:1134900582
Name:PARK PEDIATRIC DENTISTRY, LLC
Entity type:Organization
Organization Name:PARK PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:NOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-344-8034
Mailing Address - Street 1:2005 VEROT SCHOOL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6345
Mailing Address - Country:US
Mailing Address - Phone:337-344-8034
Mailing Address - Fax:
Practice Address - Street 1:2005 VEROT SCHOOL RD STE 101
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6345
Practice Address - Country:US
Practice Address - Phone:337-344-8034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty