| Fern Avenue Dental Center | |
|
7600 Fern Ave Bldg 1100 Shreveport LA 71105-5659 | |
| (318) 797-1550 | |
| Not Available |
| Full Name | Fern Avenue Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 7600 Fern Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | Paul C Heilman (DENTIST) |
| Authorized Official Contact | 3187971550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fern Avenue Dental Center 7600 Fern Ave Bldg 1100 Shreveport LA 71105-5659 Ph: (318) 797-1550 | Fern Avenue Dental Center 7600 Fern Ave Bldg 1100 Shreveport LA 71105-5659 Ph: (318) 797-1550 |
| NPI Number | 1114308582 |
|---|---|
| Provider Enumeration Date | 06/11/2015 |
| Last Update Date | 06/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114308582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3291 (Louisiana) | Primary |
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