| Shreveport Bossier Family Dental Care | |
|
3412 Barksdale Blvd 100 Bossier City LA 71112-3800 | |
| (318) 686-7470 | |
| (318) 686-4505 |
| Full Name | Shreveport Bossier Family Dental Care |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3412 Barksdale Blvd, Bossier City, Louisiana |
| Authorized Official Name and Position | Ross Dies (OWNER) |
| Authorized Official Contact | 3182134686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shreveport Bossier Family Dental Care 3412 Barksdale Blvd 100 Bossier City LA 71112-3800 Ph: (318) 686-7470 | Shreveport Bossier Family Dental Care 3412 Barksdale Blvd 100 Bossier City LA 71112-3800 Ph: (318) 686-7470 |
| NPI Number | 1972056638 |
|---|---|
| Provider Enumeration Date | 07/29/2016 |
| Last Update Date | 07/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972056638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4273 (Louisiana) | Primary |
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