Miles For Smiles, LLC
Dentist in Shreveport, LA. Organization (NPI-2).
NPI number1891173449
StatusActive
Last updated in NPPESMay 15, 2015
Details
- NPI
- 1891173449
- Entity type
- Organization (NPI-2)
- Legal business name
- Miles For Smiles, LLC
- Organization subpart
- No
- Enumeration date
- May 15, 2015
- Last updated
- May 15, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
610 Texas StShreveport, LA 71101-3554
Phone 318-317-2800
Mailing address
Po Box 78505Shreveport, LA 71137-8505
Phone 318-317-2800
Authorized official
Ashley McClenathen
Insurance Coordinator
3183172800
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