Provider Demographics
NPI:1386438539
Name:AFFORDABLE SMILES OF HOUMA, LLC
Entity type:Organization
Organization Name:AFFORDABLE SMILES OF HOUMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECILIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-609-2599
Mailing Address - Street 1:1861 MARTIN LUTHER KING BLVD.
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360
Mailing Address - Country:US
Mailing Address - Phone:985-200-4202
Mailing Address - Fax:985-200-4205
Practice Address - Street 1:1861 MARTIN LUTHER KING BLVD.
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-200-4202
Practice Address - Fax:985-200-4205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty