Blythe, David Crockett

Blythe, David Crockett is an individual health care provider with primary practice located at 401 Liberty St , Houma LA 70360-4617. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Blythe, David Crockett can be contacted via phone (985) 851-3710.

Contact Information

Primary practice address

401 Liberty St Houma LA 70360-4617

Phone: (985) 851-3710

Fax: (985) 851-3711

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Dental Providers / Oral and Maxillofacial Surgery	1223S0112X	2345	Louisiana

Profile Details

NPI number	1730249541
LBN Legal business name	Blythe, David Crockett
Credentials	Doctor of Dental Surgery (DDS)
Entity	Individual
Sole proprietor ¹	No
Enumeration date	Dec 11th, 2006
Last updated	Jul 8th, 2007 - about 17 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.

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Identifiers

State	Type	Number	Issuer
All States	NPI	1730249541	NPPES
Louisiana	MEDICAID	1823457

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