Provider Demographics
NPI:1750105953
Name:CARLITO P. ILAWAN, DDS, COVINGTON, INC
Entity type:Organization
Organization Name:CARLITO P. ILAWAN, DDS, COVINGTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLITO
Authorized Official - Middle Name:
Authorized Official - Last Name:ILAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-453-1409
Mailing Address - Street 1:400 MYRTLE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8149
Mailing Address - Country:US
Mailing Address - Phone:985-892-2711
Mailing Address - Fax:
Practice Address - Street 1:400 MYRTLE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8149
Practice Address - Country:US
Practice Address - Phone:985-892-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty