| Arklatex Oral & Maxillofacial Surgery A Partnership Of Professional De | |
|
7600 Fern Ave Building 1400 Shreveport LA 71105-5659 | |
| (318) 797-5812 | |
| Not Available |
| Full Name | Arklatex Oral & Maxillofacial Surgery A Partnership Of Professional De |
|---|---|
| Speciality | Dentist |
| Location | 7600 Fern Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | Brian R Smith (PRESIDENT) |
| Authorized Official Contact | 3187975812 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arklatex Oral & Maxillofacial Surgery A Partnership Of Professional De 7600 Fern Ave Building 1400 Shreveport LA 71105-5659 Ph: (318) 797-5812 | Arklatex Oral & Maxillofacial Surgery A Partnership Of Professional De 7600 Fern Ave Building 1400 Shreveport LA 71105-5659 Ph: (318) 797-5812 |
| NPI Number | 1003092545 |
|---|---|
| Provider Enumeration Date | 01/15/2008 |
| Last Update Date | 02/02/2011 |
| Medicare PECOS PAC ID | 9739376864 |
|---|---|
| Medicare Enrollment ID | O20101215000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003092545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Brian R Smith |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1639191182 PECOS PAC ID: 6305733817 Enrollment ID: I20040413000823 |
| Provider Name | Jason H Lustig |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1750347498 PECOS PAC ID: 8820179898 Enrollment ID: I20080116000004 |
| Provider Name | Andrew R Banker |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1336359744 PECOS PAC ID: 2668641804 Enrollment ID: I20110804000600 |
| Provider Name | Benjamin W Johnson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1952538092 PECOS PAC ID: 4587936067 Enrollment ID: I20170817002785 |
| Provider Name | Wendell W Neeley |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1285806810 PECOS PAC ID: 9133424245 Enrollment ID: I20180515001560 |
| Provider Name | Colten W Ducote |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1093122202 PECOS PAC ID: 4486874278 Enrollment ID: I20200720001425 |
Scruggs Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 E. 70th Street, Suite 105, Shreveport, LA 71005 Phone: 318-798-2008 | |
David J Bellew Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1945 E 70th St, Ste D, Shreveport, LA 71105 Phone: 318-797-4550 Fax: 318-797-4565 | |
Taylor Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9018 Mansfield Rd, Shreveport, LA 71118 Phone: 800-920-9947 Fax: 678-247-7858 | |
Ivy Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Ashley Ridge Blvd Ste 600, Shreveport, LA 71106 Phone: 318-868-4188 Fax: 318-868-9151 | |
Pediatric Dental Partners, Llp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 318 Carroll St., Shreveport, LA 71105 Phone: 318-865-2250 Fax: 318-865-3751 | |
Traveling Light Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 Carroll St, Suite 3, Shreveport, LA 71105 Phone: 318-869-2593 Fax: 318-869-2592 |