| H. O. Blackwood, D.d.s. Apdc | |
|
814 Pierremont Rd Shreveport LA 71106-2034 | |
| (318) 865-8478 | |
| Not Available |
| Full Name | H. O. Blackwood, D.d.s. Apdc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 814 Pierremont Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Laura Ardoin (OFFICE MANAGER) |
| Authorized Official Contact | 3188658478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| H. O. Blackwood, D.d.s. Apdc 814 Pierremont Rd Shreveport LA 71106-2034 Ph: (318) 865-8478 | H. O. Blackwood, D.d.s. Apdc 814 Pierremont Rd Shreveport LA 71106-2034 Ph: (318) 865-8478 |
| NPI Number | 1689862260 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 10/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689862260 | NPI | - | NPPES |
| 1816124 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 1612 (Louisiana) | Primary |
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