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1932243094
RICHARD C VANDIVER
SHREVEPORT, LA
NPI
1932243094
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA 4538)
Enumeration Date
2007-02-20
Last Update Date
2023-03-07
Business Address
Dr. RICHARD C VANDIVER DDS
1625 DAVID RAINES RD
SHREVEPORT, LA 71107-5899
Phone number: 318-841-6048
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Mailing Address
Dr. RICHARD C VANDIVER DDS
2125 E BERT KOUNS INDUSTRIAL LOOP UNIT #3
SHREVEPORT, LA 71105-5314
Phone number: 318-349-1909
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