Provider Demographics
NPI:1720430556
Name:ALLURE DENTAL BY DANIELA SK EVERSGERD DMD LLC
Entity Type:Organization
Organization Name:ALLURE DENTAL BY DANIELA SK EVERSGERD DMD LLC
Other - Org Name:ALLURE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:SCHWAMBACH KANO
Authorized Official - Last Name:EVERSGERD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:985-951-2220
Mailing Address - Street 1:103 ROSEDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-8219
Mailing Address - Country:US
Mailing Address - Phone:985-237-2750
Mailing Address - Fax:
Practice Address - Street 1:1901 HIGHWAY 190
Practice Address - Street 2:SUITE 14
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-3470
Practice Address - Country:US
Practice Address - Phone:985-951-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6434122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty