Provider Demographics
NPI:1699165530
Name:LAPLACE DENTAL ASSOCIATES, LLC: DR. JOSEPH R. LACOSTE, JR., DR. THAI N
Entity type:Organization
Organization Name:LAPLACE DENTAL ASSOCIATES, LLC: DR. JOSEPH R. LACOSTE, JR., DR. THAI N
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:LACOSTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-893-2240
Mailing Address - Street 1:600 N HIGHWAY 190
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:393 BELLE TERRE BLVD.
Practice Address - Street 2:
Practice Address - City:LAPLACE
Practice Address - State:LA
Practice Address - Zip Code:70068
Practice Address - Country:US
Practice Address - Phone:985-893-2240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty