JASON HAROLD LUSTIG

SHREVEPORT, LA
NPI1750347498
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: LA  5776)
Additional Taxonomies1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: NJ  22D102219000)
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: NY  050487)
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: NY  227864)
Enumeration Date2006-04-21
Last Update Date2007-07-24
Business Address
-- JASON HAROLD LUSTIG DDS MD
7600 FERN AVE BUILDING 1400
SHREVEPORT, LA 71105-5659
Phone number: 318-797-5812
Mailing Address
-- JASON HAROLD LUSTIG DDS MD
7600 FERN AVE BUILDING 1400
SHREVEPORT, LA 71105-5659
Phone number: 318-797-5812