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1932290160
MICHAEL THOMAS FAVALORO
LUTCHER, LA
NPI
1932290160
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA 5718)
Enumeration Date
2006-09-26
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL THOMAS FAVALORO d d s
2024 WEST MAIN STREET
LUTCHER, LA 70071
Phone number: 225-869-8281
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Mailing Address
Dr. MICHAEL THOMAS FAVALORO d d s
3500 REDWOOD LN
PAULINA, LA 70763-2320
Phone number: 225-869-4811
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