Provider Demographics
NPI:1134244825
Name:ACADIAN FAMILY DENTISTRY
Entity type:Organization
Organization Name:ACADIAN FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUHON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-981-9923
Mailing Address - Street 1:3233 AMBASSADOR CAFFERY PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506
Mailing Address - Country:US
Mailing Address - Phone:337-981-9923
Mailing Address - Fax:337-981-9983
Practice Address - Street 1:3233 AMBASSADOR CAFFERY PARKWAY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506
Practice Address - Country:US
Practice Address - Phone:337-981-9923
Practice Address - Fax:337-981-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA33951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH6154OtherBLUE CROSS PROVIDER #
LAG8140OtherBLUE CROSS PROVIDER #