Provider Demographics
NPI:1285758789
Name:JAMES A HEURTIN DDS LTD
Entity type:Organization
Organization Name:JAMES A HEURTIN DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HEURTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-392-6057
Mailing Address - Street 1:250 MEADOWCREST ST
Mailing Address - Street 2:STE 100
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056
Mailing Address - Country:US
Mailing Address - Phone:504-392-6057
Mailing Address - Fax:504-391-2429
Practice Address - Street 1:250 MEADOWCREST ST
Practice Address - Street 2:STE 100
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056
Practice Address - Country:US
Practice Address - Phone:504-392-6057
Practice Address - Fax:504-391-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA2061122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty