| Southern Roots Dental Of Louisiana | |
|
1401 N 18th St Ste E Monroe LA 71201-4972 | |
| (318) 605-2015 | |
| (318) 737-1239 |
| Full Name | Southern Roots Dental Of Louisiana |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1401 N 18th St Ste E, Monroe, Louisiana |
| Authorized Official Name and Position | Julie Lebell Simpson (OWNER DENTIST) |
| Authorized Official Contact | 3186052015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Roots Dental Of Louisiana 1503 Spencer Ave Monroe LA 71201-4149 Ph: (318) 557-6338 | Southern Roots Dental Of Louisiana 1401 N 18th St Ste E Monroe LA 71201-4972 Ph: (318) 605-2015 |
| NPI Number | 1942715917 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 12/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942715917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Louisiana) | Primary |
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