Roslyn Faulk

Individual provider Active NPI Dental Assistant · Frot Polk, LA

NPI 1306298997 · NPPES record last updated Jul 7, 2016

Key facts

NPI
1306298997
Entity type
Individual (NPI type 1)
Primary specialty
Dental Assistant 126800000X
Practice address
7223 Mississippi Avenut
Frot Polk, LA 71459
Phone
(337) 531-4940
NPI assigned
Jul 7, 2016
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X Yes

Addresses

Primary practice location

7223 Mississippi Avenut
Frot Polk, LA 71459

Mailing address

7223 Mississippi Avenut
Frot Polk, LA 71459

Sources for this page

Verify at the official NPI Registry.