Provider Demographics
NPI:1720241383
Name:DAIGLE, EVA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:MARIE
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 GOVERNMENT ST STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6238
Mailing Address - Country:US
Mailing Address - Phone:225-924-1824
Mailing Address - Fax:225-925-3168
Practice Address - Street 1:6509 GOVERNMENT ST STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6238
Practice Address - Country:US
Practice Address - Phone:225-924-1824
Practice Address - Fax:225-925-3168
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist