| Traveling Light Dental Llc | |
|
230 Carroll St Suite 3 Shreveport LA 71105 | |
| (318) 869-2593 | |
| (318) 869-2592 |
| Full Name | Traveling Light Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 230 Carroll St, Shreveport, Louisiana |
| Authorized Official Name and Position | Benjamin Mark Kacos (DENTIST) |
| Authorized Official Contact | 3188692593 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Traveling Light Dental Llc 230 Carroll St Suite 3 Shreveport LA 71105 Ph: (318) 869-2593 | Traveling Light Dental Llc 230 Carroll St Suite 3 Shreveport LA 71105 Ph: (318) 869-2593 |
| NPI Number | 1083282537 |
|---|---|
| Provider Enumeration Date | 06/11/2021 |
| Last Update Date | 06/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083282537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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