| Organization Name: | DENTAL CARE GROUP |
| NPI Number: | 1003245226 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CATRINEL JORDAN (DENTIST/ OWNER) |
| Mailing Address: | 16270 Airline Hwy Ste. B Prairieville |
| State: | LA US |
| Postal Code: | 707694589 |
| Phone Number: | 2256731557 |
| Fax Number: | 2256736815 |
| NPI Enumeration Date: | 11/07/2013 |
| NPI Last Update Date: | 01/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 6275 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |