Wyatt Dental Group, LLC

NPI #1780901355 in Metairie, Louisiana

Provider Information

NPI Number: 1780901355
Entity Type: Organization
Organization Name: Wyatt Dental Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: LISA WYATT, D.D.S.
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 22, 2010
Last Updated: Apr 22, 2010

Practice Location

Address: 5037 VETERANS MEMORIAL BLVD
Address 2: STE 3E
City: Metairie
State: Louisiana
ZIP Code: 70006-5136
Phone: (504) 885-1039

Authorized Official

Name: DR. LISA WYATT, DDS
Title: OWNER/DENTIST
Phone: (504) 885-1039

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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