Provider Demographics
NPI:1164269429
Name:MESTAYER, DENNIS ANTHONY (RPH)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:ANTHONY
Last Name:MESTAYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 WEBER ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538
Mailing Address - Country:US
Mailing Address - Phone:337-828-2550
Mailing Address - Fax:337-828-2791
Practice Address - Street 1:1115 WEBER ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538
Practice Address - Country:US
Practice Address - Phone:337-828-2550
Practice Address - Fax:337-828-2791
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.008393-G183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist