| Boyd Dds Llc | |
|
2042 Line Ave Shreveport LA 71104-2125 | |
| (318) 425-5356 | |
| (318) 674-2898 |
| Full Name | Boyd Dds Llc |
|---|---|
| Speciality | Dentist |
| Location | 2042 Line Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | Mckenzy K Boyd (OWNER) |
| Authorized Official Contact | 3184255356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boyd Dds Llc 2042 Line Ave Shreveport LA 71104-2125 Ph: (318) 425-5356 | Boyd Dds Llc 2042 Line Ave Shreveport LA 71104-2125 Ph: (318) 425-5356 |
| NPI Number | 1124568332 |
|---|---|
| Provider Enumeration Date | 03/07/2017 |
| Last Update Date | 03/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124568332 | NPI | - | NPPES |
| 1457664906 | Other | LA | NPI |
| 1003124397 | Other | LA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6190 (Louisiana) | Primary |
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