Provider Demographics
NPI:1811447055
Name:TROY M. VERGES DDS INC.
Entity type:Organization
Organization Name:TROY M. VERGES DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:VERGES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-229-3973
Mailing Address - Street 1:207 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:70444-2803
Mailing Address - Country:US
Mailing Address - Phone:985-229-3973
Mailing Address - Fax:985-229-3972
Practice Address - Street 1:207 AVENUE G
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:LA
Practice Address - Zip Code:70444-2803
Practice Address - Country:US
Practice Address - Phone:985-229-3973
Practice Address - Fax:985-229-3972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty