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1942211107
DANIEL MACK DENNIS
SHREVEPORT, LA
NPI
1942211107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: LA 15709)
Enumeration Date
2006-08-11
Last Update Date
2007-07-08
Business Address
Mr. DANIEL MACK DENNIS R.PH.
510 E STONER AVE
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
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Mailing Address
Mr. DANIEL MACK DENNIS R.PH.
3117 DEERFIELD DR
HAUGHTON, LA 71037-8500
Phone number: 318-390-7088
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