| Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc | |
|
9445 Stevens Rd Ste 120 Shreveport LA 71106 | |
| (918) 473-8113 | |
| Not Available |
| Full Name | Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9445 Stevens Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Haley Wooster (ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 7127338551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc 9445 Stevens Rd Ste 120 Shreveport LA 71106 Ph: () - | Thomas Kennedy, Dds Of Louisiana Ii, A Professional Dental Llc 9445 Stevens Rd Ste 120 Shreveport LA 71106 Ph: (918) 473-8113 |
| NPI Number | 1912251315 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912251315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6219 (Louisiana) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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