Provider Demographics
NPI:1154438109
Name:DORE, DANIELLE ARDOIN (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ARDOIN
Last Name:DORE
Suffix:
Gender:F
Credentials:DDS
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Other - First Name:
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Mailing Address - Street 1:1144 COOLIDGE BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2622
Mailing Address - Country:US
Mailing Address - Phone:337-267-7645
Mailing Address - Fax:337-234-2881
Practice Address - Street 1:1144 COOLIDGE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2622
Practice Address - Country:US
Practice Address - Phone:337-267-7645
Practice Address - Fax:337-234-2881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA49521223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics