Provider Demographics
NPI:1265840664
Name:LOUISIANA DENTAL SLEEP MEDICINE CENTER, LLC
Entity type:Organization
Organization Name:LOUISIANA DENTAL SLEEP MEDICINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEJEUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-937-6560
Mailing Address - Street 1:3138 MCILHENNY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-8655
Mailing Address - Country:US
Mailing Address - Phone:225-937-6560
Mailing Address - Fax:225-248-8800
Practice Address - Street 1:3138 MCILHENNY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-8655
Practice Address - Country:US
Practice Address - Phone:225-937-6560
Practice Address - Fax:225-248-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA 4447332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment