| NPI | 1285302737 |
|---|---|
| Doing Business As | SOUTHERN ROOTS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ABIGAIL HOWELL Practice Manager 318-294-2241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-08-31 |