Provider Demographics
NPI:1336339514
Name:PLAISANCE, NICHOLAS ANTOINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANTOINE
Last Name:PLAISANCE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:NICHOLAS
Other - Middle Name:A
Other - Last Name:PLAISANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:101 EAST 59TH STREET
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345
Mailing Address - Country:US
Mailing Address - Phone:985-632-7666
Mailing Address - Fax:985-632-8889
Practice Address - Street 1:101 EAST 59TH STREET
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345
Practice Address - Country:US
Practice Address - Phone:985-632-7666
Practice Address - Fax:985-632-8889
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA28601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics