Provider Demographics
NPI:1336767870
Name:ROLFSEN, CAROLINE CAZAYOUX (DDS)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CAZAYOUX
Last Name:ROLFSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:NOELLE
Other - Last Name:CAZAYOUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:339 38TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124
Mailing Address - Country:US
Mailing Address - Phone:337-349-1341
Mailing Address - Fax:
Practice Address - Street 1:925 E HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4719
Practice Address - Country:US
Practice Address - Phone:225-390-1277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA72851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2872851Medicaid