Bergeron, Randall August
Bergeron, Randall August is an sole proprietor health care provider with primary practice located at 7930 Wrenwood Blvd Ste B, Baton Rouge LA 70809-7700. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bergeron, Randall August can be contacted via phone (225) 924-3635.Contact Information
Primary practice address
7930 Wrenwood Blvd Ste B
Baton Rouge LA 70809-7700
Phone: (225) 924-3635
Fax: (225) 924-3736
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 3809 | Louisiana |
Profile Details
| NPI number | 1275612376 |
|---|---|
| LBN Legal business name | Bergeron, Randall August |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 2nd, 2006 |
| Last updated | Dec 12th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275612376 | NPPES |
| Louisiana | MEDICAID | 1838098 |
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