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3735 Jewella Ave Shreveport LA 71109-4703 | |
| (800) 920-9947 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3735 Jewella Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | David M V Ieth (PRESIDENT) |
| Authorized Official Contact | 7709165036 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 Ph: (770) 916-5028 | 3735 Jewella Ave Shreveport LA 71109-4703 Ph: (800) 920-9947 |
| NPI Number | 1346571866 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 03/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346571866 | NPI | - | NPPES |
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