| NPI | 1851779623 |
|---|---|
| Doing Business As | PEDIATRIC DENTISTRY OF SHREVEPORT-BOSSIER |
| Entity Type | Organization |
| Authorized Contact | CAROL A LLOYD Office Manager 318-742-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6422) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 2217) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6485) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6224) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6532) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-13 |