Country Club Dental
Country Club Dental is a General Practice Dentistry in Baton Rouge, Louisiana. Licensed in Louisiana. Registered with an NPI since 2006.
- Licensed in
- LA
- In the registry since
- 2006
Practice location Address checks out
16645 Highland Rd Ste JBaton Rouge, LA 70810-6567
Phone: (225) 214-0100
Fax: (225) 214-0103
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 5312 (LA) |
|---|
Record details
| NPI number | 1003970682 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Darrell Bourg — Dentist · (504) 232-6624 |
| Other names | Louisiana Dental Spa |
| NPI enumerated | December 20, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 16645 Highland Rd Ste J, Baton Rouge, LA 70810-6567 |
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