Joseph Oliver Laprairie Jr., DDS

Individual provider Active NPI General Practice Dentistry · Bunkie, LA

NPI 1194889857 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1194889857
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2364 (LA)
Practice address
117 W Magnolia St
Bunkie, LA 71322-1777
Phone
(318) 346-6774
Fax
(318) 346-6776
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2364LAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2364 LA Yes

Addresses

Primary practice location

117 W Magnolia St
Bunkie, LA 71322-1777

Mailing address

PO Box 230
Bunkie, LA 71322-0230
Phone (318) 346-6774

Other identifiers

IdentifierTypeStateIssuer
1823643MedicaidLA

Other providers in Bunkie, LA

All providers in Bunkie, LA · General Practice Dentistry in Louisiana

Sources for this page

Verify at the official NPI Registry.