Provider Demographics
NPI:1982892584
Name:AUBREY A. BAUDEAN, JR., DDS
Entity type:Organization
Organization Name:AUBREY A. BAUDEAN, JR., DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAUDEAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:GENERAL DENTIST
Authorized Official - Phone:504-347-1015
Mailing Address - Street 1:2446 BARATARIA BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-5345
Mailing Address - Country:US
Mailing Address - Phone:504-347-1015
Mailing Address - Fax:504-341-8867
Practice Address - Street 1:2446 BARATARIA BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-5345
Practice Address - Country:US
Practice Address - Phone:504-347-1015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty