| NPI | 1821722240 |
|---|---|
| Doing Business As | SOUTHERN ROOTS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ABIGAIL RENEE HOWELL Practice Management 318-294-2241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |