Provider Demographics
NPI:1952421497
Name:LEBLANC, MICHAEL FRANCES SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCES
Last Name:LEBLANC
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CANAL BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4506
Mailing Address - Country:US
Mailing Address - Phone:985-446-1917
Mailing Address - Fax:985-446-1918
Practice Address - Street 1:900 CANAL BLVD STE 1
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4506
Practice Address - Country:US
Practice Address - Phone:985-446-1917
Practice Address - Fax:985-446-1918
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA27271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice