| NPI | 1972056638 |
|---|---|
| Doing Business As | SHREVEPORT BOSSIER FAMILY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ROSS DIES Owner 318-213-4686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 4273) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |