Provider Demographics
NPI:1265620942
Name:BRINDIS, MARCO ANTONIO (DDS)
Entity type:Individual
Prefix:
First Name:MARCO
Middle Name:ANTONIO
Last Name:BRINDIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 HOUMA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-3005
Mailing Address - Country:US
Mailing Address - Phone:504-883-3737
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3005
Practice Address - Country:US
Practice Address - Phone:504-883-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics