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4325 Airline Dr Bossier City LA 71111-3465 | |
| (318) 742-9333 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4325 Airline Dr, Bossier City, Louisiana |
| Authorized Official Name and Position | Kristal Patterson (OFFICE MANAGER) |
| Authorized Official Contact | 3187429333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4325 Airline Dr Bossier City LA 71111-3465 Ph: (318) 742-9333 | 4325 Airline Dr Bossier City LA 71111-3465 Ph: (318) 742-9333 |
| NPI Number | 1750159737 |
|---|---|
| Provider Enumeration Date | 12/19/2023 |
| Last Update Date | 07/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750159737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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Pope W Oden Iii Dds Apdc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2285 Benton Road, D103, Bossier City, LA 71111 Phone: 318-747-7978 Fax: 318-747-7978 | |
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