Provider Demographics
NPI:1316169030
Name:MCCONNELL, HIRAM A (DDS)
Entity type:Individual
Prefix:DR
First Name:HIRAM
Middle Name:A
Last Name:MCCONNELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1231 COOLIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2620
Mailing Address - Country:US
Mailing Address - Phone:337-233-6580
Mailing Address - Fax:337-233-8616
Practice Address - Street 1:1231 COOLIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2620
Practice Address - Country:US
Practice Address - Phone:337-233-6580
Practice Address - Fax:337-233-8616
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA20011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery