Darrell P. Bourg Jr. Dds in Jefferson - General Practice
Darrell P. Bourg Jr. Dds - NPI 1740344225
Darrell P. Bourg Jr. Dds is a General Practice in Jefferson, Louisiana. Darrell P. Bourg Jr. Dds practices all healthcare services and medical treatments related to General Practice. The NPI Number for Darrell P. Bourg Jr. Dds is 1740344225. The last update date is 2020-08-22.
Darrell P. Bourg Jr. Dds's current location address is 21 San Carlos Ave, Jefferson, Louisiana. You can contact this provider via phone number 5046216338 and fax number 5043407207. The mailing address for Darrell P. Bourg Jr. Dds is 21 San Carlos Ave, Jefferson, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Darrell P. Bourg Jr. Dds |
|---|---|
| Address | 21 San Carlos Ave, Jefferson, Louisiana |
| Phone Number | 5046216338 |
| Fax Number | 5043407207 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Bourg Paul Darrell |
| Credentials | DDS |
| Telephone Number | 5043409696 |
NPI Number Detail
| NPI Number | 1740344225 |
|---|---|
| Provider Enumeration Date | 2006-12-20 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 21 San Carlos Ave |
|---|---|
| City | Jefferson |
| State | Louisiana (LA) |
| Post Code | 701212240 |
| Phone Number | 5046216338 |
| Fax Number | 5043407207 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 5747 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique identification code assigned to Darrell P. Bourg Jr. Dds by the Centers for Medicare & Medicaid Services?
The Darrell P. Bourg Jr. Dds has been issued the NPI (National Provider Identifier) 1740344225. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Darrell P. Bourg Jr. Dds's facilities are situated?
The facilities of Darrell P. Bourg Jr. Dds are physically located at the following address: 21 San Carlos Ave, Jefferson, LA, 701212240.
What is the Darrell P. Bourg Jr. Dds's specialty and taxonomy code?
The Darrell P. Bourg Jr. Dds's specialty is General Practice, and the corresponding taxonomy code is 1223G0001X.
On what date was the 1740344225 assigned to Darrell P. Bourg Jr. Dds?
The Darrell P. Bourg Jr. Dds was issued its 1740344225 on 2006-12-20, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Darrell P. Bourg Jr. Dds most recently updated?
The details pertaining to the Darrell P. Bourg Jr. Dds, including its address, specialty, and other relevant information, were last refreshed on 2020-08-22.
NPI Number: 1417950320
Address: 1395 Center Drive, D7-6a, Box 100416, Gainesville, FL