Shreveport Periodontal Specialists
NPI #1720803356 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1720803356
- Entity Type
- Organization
- Organization Name
- Shreveport Periodontal Specialists
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Nov 19, 2024
- Last Updated
- Nov 19, 2024
Practice Location
- Address
- 745 EDGEMONT ST
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71106-2246
- Phone
- (318) 868-0535
Authorized Official
- Name
- ANGELA WATSON
- Title
- COO
- Phone
- (318) 868-0535
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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