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1700173069
BENJAMIN MARK KACOS
SHREVEPORT, LA
NPI
1700173069
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA 6201)
Enumeration Date
2011-07-06
Last Update Date
2011-07-06
Business Address
Dr. BENJAMIN MARK KACOS D.M.D.
3100 WOODLAWN AVE SUITE C
SHREVEPORT, LA 71104-4637
Phone number: 318-868-8276
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Mailing Address
Dr. BENJAMIN MARK KACOS D.M.D.
3100 WOODLAWN AVE SUITE C
SHREVEPORT, LA 71104-4637
Phone number: 318-868-8276
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