Provider Demographics
NPI:1043701261
Name:PEDRO J. CUARTAS, DDS, APDC
Entity type:Organization
Organization Name:PEDRO J. CUARTAS, DDS, APDC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CUARTAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-872-3677
Mailing Address - Street 1:600 VALHI BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5976
Mailing Address - Country:US
Mailing Address - Phone:985-872-3677
Mailing Address - Fax:
Practice Address - Street 1:600 VALHI BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-872-3677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA5237261QD0000X
LA5237261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental