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1215053558
DARRELL P BOURG
MARRERO, LA
NPI
1215053558
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA 5312)
Enumeration Date
2007-03-21
Last Update Date
2021-02-08
Business Address
Dr. DARRELL P BOURG D.D.S.
2521 AMES BLVD., STE. C
MARRERO, LA 70072-5154
Phone number: 504-340-9696
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Mailing Address
Dr. DARRELL P BOURG D.D.S.
2521 AMES BLVD., STE. C
MARRERO, LA 70072-5154
Phone number: 504-340-9696
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