Provider Demographics
NPI:1902060437
Name:CRESSON, GUY GERARD (DDS)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:GERARD
Last Name:CRESSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-5014
Mailing Address - Country:US
Mailing Address - Phone:504-831-6900
Mailing Address - Fax:504-837-0003
Practice Address - Street 1:1569 LAKE AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-5014
Practice Address - Country:US
Practice Address - Phone:504-831-6900
Practice Address - Fax:504-837-0003
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA33861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice