NINTA SOUTHICHACK

SHREVEPORT, LA
NPI1629777636
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: LA  7641)
Additional Taxonomies122300000X Dentist
(Licence: TX  40137)
Enumeration Date2023-02-28
Last Update Date2025-02-24
Business Address
NINTA SOUTHICHACK
230 CARROLL ST STE 3
SHREVEPORT, LA 71105-4248
Phone number: 318-693-0091
Mailing Address
NINTA SOUTHICHACK
1400 TOPLEA DR
EULESS, TX 76040-4976
Phone number: 682-203-8530
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