| Southern Roots Dentistry | |
|
126 Jefferson St Mansfield LA 71052-2600 | |
| (318) 872-1557 | |
| Not Available |
| Full Name | Southern Roots Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 126 Jefferson St, Mansfield, Louisiana |
| Authorized Official Name and Position | Abigail Howell (PRACTICE MANAGER) |
| Authorized Official Contact | 3182942241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Roots Dentistry 126 Jefferson St Mansfield LA 71052-2600 Ph: (318) 872-1557 | Southern Roots Dentistry 126 Jefferson St Mansfield LA 71052-2600 Ph: (318) 872-1557 |
| NPI Number | 1285302737 |
|---|---|
| Provider Enumeration Date | 08/31/2021 |
| Last Update Date | 08/31/2021 |
| Certification Date | 08/31/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285302737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
| 261QD0000X | Clinic/center - Dental | () | Secondary |
Andrew G Murphy DDS Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 Jefferson St, Mansfield, LA 71052 Phone: 318-872-1557 Fax: 318-872-3064 |