Provider Demographics
NPI:1881969939
Name:BARRAS FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:BARRAS FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-235-3395
Mailing Address - Street 1:116 RUE BEAUREGARD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3102
Mailing Address - Country:US
Mailing Address - Phone:337-235-3395
Mailing Address - Fax:337-234-5789
Practice Address - Street 1:116 RUE BEAUREGARD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3102
Practice Address - Country:US
Practice Address - Phone:337-235-3395
Practice Address - Fax:337-234-5789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA56221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty