Provider Demographics
NPI:1427254861
Name:FUGETTA, DARAH L (DDS)
Entity type:Individual
Prefix:MISS
First Name:DARAH
Middle Name:L
Last Name:FUGETTA
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 1:107 OAK WAY LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506
Mailing Address - Country:US
Mailing Address - Phone:337-408-3933
Mailing Address - Fax:337-456-3963
Practice Address - Street 1:107 OAK WAY LN.
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506
Practice Address - Country:US
Practice Address - Phone:337-408-3933
Practice Address - Fax:337-456-3963
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA5637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist