Provider Demographics
NPI:1336589530
Name:LACOUR, LETITIA AMELIE (DDS)
Entity type:Individual
Prefix:DR
First Name:LETITIA
Middle Name:AMELIE
Last Name:LACOUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LAKE MARINA AVE
Mailing Address - Street 2:APT 328
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1668
Mailing Address - Country:US
Mailing Address - Phone:504-874-1778
Mailing Address - Fax:
Practice Address - Street 1:500 LAKE MARINA AVE
Practice Address - Street 2:APT 328
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-1668
Practice Address - Country:US
Practice Address - Phone:504-874-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAS-747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist