| |
207 Serio Blvd Ferriday LA 71334-2014 | |
(318) 757-4561 | |
(318) 757-4595 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 207 Serio Blvd, Ferriday, Louisiana |
Authorized Official Name and Position | James V Iverstine (DENTIST) |
Authorized Official Contact | 3187574561 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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207 Serio Blvd Ferriday LA 71334-2014 Ph: (318) 757-4561 | 207 Serio Blvd Ferriday LA 71334-2014 Ph: (318) 757-4561 |
NPI Number | 1417250382 |
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Provider Enumeration Date | 12/14/2010 |
Last Update Date | 12/14/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417250382 | NPI | - | NPPES |
1834190 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Tom T. Milliken, Dds Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1810 Ee Wallace Blvd N Ste 2, Ferriday, LA 71334 Phone: 318-757-9370 |