| Spd Llc | |
|
1416 Hazel St Arcadia LA 71001-4114 | |
| (318) 855-1426 | |
| (318) 579-5038 |
| Full Name | Spd Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1416 Hazel St, Arcadia, Louisiana |
| Authorized Official Name and Position | Kyle Gresham (MEMBER) |
| Authorized Official Contact | 3188551426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spd Llc 1416 Hazel St Arcadia LA 71001-4114 Ph: () - | Spd Llc 1416 Hazel St Arcadia LA 71001-4114 Ph: (318) 855-1426 |
| NPI Number | 1528729555 |
|---|---|
| Provider Enumeration Date | 01/03/2022 |
| Last Update Date | 01/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528729555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Southern Pines Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1416 Hazel St, Arcadia, LA 71001 Phone: 318-855-1426 Fax: 318-579-5038 |