| Shreveport Periodontal Specialists | |
|
745 Edgemont St Shreveport LA 71106-2246 | |
| (318) 868-0535 | |
| (318) 868-0572 |
| Full Name | Shreveport Periodontal Specialists |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 745 Edgemont St, Shreveport, Louisiana |
| Authorized Official Name and Position | Angela Watson (COO) |
| Authorized Official Contact | 3188680535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shreveport Periodontal Specialists 745 Edgemont St Shreveport LA 71106-2246 Ph: (318) 868-0535 | Shreveport Periodontal Specialists 745 Edgemont St Shreveport LA 71106-2246 Ph: (318) 868-0535 |
| NPI Number | 1720803356 |
|---|---|
| Provider Enumeration Date | 11/19/2024 |
| Last Update Date | 11/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720803356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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