DAKOTA BOSTON

SHREVEPORT, LA
NPI1962899971
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
(Licence: LA  MD.307727)
Additional Taxonomies207R00000X Internal Medicine
(Licence: LA  MD.307727)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2015-04-17
Last Update Date2022-07-12
Business Address
DAKOTA BOSTON MD
1811 E BERT KOUNS INDUSTRIAL LOOP STE 480
SHREVEPORT, LA 71105-5765
Phone number: 318-212-2810
Mailing Address
DAKOTA BOSTON MD
2449 HOSPITAL DR STE 400
BOSSIER CITY, LA 71111-1914
Phone number: 182-127-9023
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