Provider Demographics
NPI:1992839583
Name:JOACHIM, SHELLY MARGARET (DDS)
Entity type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:MARGARET
Last Name:JOACHIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:4451 BLUEBONNET BLVD
Mailing Address - Street 2:STE F
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-767-2273
Mailing Address - Fax:225-223-6250
Practice Address - Street 1:13707 COURSEY BLVD. STE. A
Practice Address - Street 2:BLUEBONNET DENTAL CARE AT COURSEY
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817
Practice Address - Country:US
Practice Address - Phone:225-752-5241
Practice Address - Fax:225-752-8691
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LALA5031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist