Provider Demographics
NPI:1104496744
Name:ST. TAMMANY PERIODONTICS & IMPLANTS LLC
Entity type:Organization
Organization Name:ST. TAMMANY PERIODONTICS & IMPLANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAESAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:SWEIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-778-0241
Mailing Address - Street 1:5024 KEYSTONE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7517
Mailing Address - Country:US
Mailing Address - Phone:985-778-0241
Mailing Address - Fax:985-778-0428
Practice Address - Street 1:5024 KEYSTONE BLVD STE A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7517
Practice Address - Country:US
Practice Address - Phone:985-778-0241
Practice Address - Fax:985-778-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty