| Organization Name: | EDWIN L BERCIER IV DDS |
| NPI Number: | 1689968695 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWIN L BERCIER (OWNER) |
| Mailing Address: | 300 N Polk St Rayne |
| State: | LA US |
| Postal Code: | 705786551 |
| Phone Number: | 3373343581 |
| Fax Number: | 3373342812 |
| NPI Enumeration Date: | 06/07/2011 |
| NPI Last Update Date: | 06/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |