Laurie R. Glaser, D.D.S.

Individual provider Active NPI General Practice Dentistry · Boutte, LA

NPI 1265582464 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1265582464
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5328 (LA)
Practice address
13270 Highway 90
Boutte, LA 70039
Phone
(985) 785-0123
Fax
(985) 785-0125
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
5328LAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Glaser Family Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5328 LA Yes

Addresses

Primary practice location

13270 Highway 90
Boutte, LA 70039

Mailing address

PO Box 515
Boutte, LA 70039-0515
Phone (985) 785-0123

Other providers in Boutte, LA

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

Sources for this page

Verify at the official NPI Registry.