Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 6897 | LA |
NPI | 1003283326 |
---|---|
Provider Name | Dr. Panagiotis Dragonas |
First Address | New Orleans, LA 70113-1969 |
Second Address | New Orleans, LA 70119-2715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2015 |
Last Update Date | 01/04/2019 |