| Wk Oral And Maxillofacial Surgery Institute | |
|
2508 Bert Kouns Industrial Loop Ste 410 Shreveport LA 71118-3157 | |
| (318) 716-4939 | |
| Not Available |
| Full Name | Wk Oral And Maxillofacial Surgery Institute |
|---|---|
| Speciality | Dentist |
| Location | 2508 Bert Kouns Industrial Loop Ste 410, Shreveport, Louisiana |
| Authorized Official Name and Position | Mary Jane Ward (SENIOR VP FINANCE) |
| Authorized Official Contact | 3187164937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wk Oral And Maxillofacial Surgery Institute 2508 Bert Kouns Industrial Loop Ste 410 Shreveport LA 71118-3157 Ph: (318) 716-4939 | Wk Oral And Maxillofacial Surgery Institute 2508 Bert Kouns Industrial Loop Ste 410 Shreveport LA 71118-3157 Ph: (318) 716-4939 |
| NPI Number | 1104584515 |
|---|---|
| Provider Enumeration Date | 12/02/2021 |
| Last Update Date | 12/02/2021 |
| Medicare PECOS PAC ID | 6002203767 |
|---|---|
| Medicare Enrollment ID | O20220427001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104584515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Ghali E Ghali |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1417981739 PECOS PAC ID: 3971518408 Enrollment ID: I20060220000458 |
| Provider Name | Brett M Shirley |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1467624973 PECOS PAC ID: 0042436362 Enrollment ID: I20151215002575 |
| Provider Name | Stavan Y Patel |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1558688309 PECOS PAC ID: 6507161817 Enrollment ID: I20160721001012 |
| Provider Name | Ross David Brockman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427587054 PECOS PAC ID: 6800244898 Enrollment ID: I20231201000989 |
Arklatex Oral & Maxillofacial Surgery A Partnership Of Professional De Dental Clinic Medicare: Medicare Enrolled Practice Location: 7600 Fern Ave, Building 1400, Shreveport, LA 71105 Phone: 318-797-5812 | |
Scruggs Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 E. 70th Street, Suite 105, Shreveport, LA 71005 Phone: 318-798-2008 | |
David J Bellew Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1945 E 70th St, Ste D, Shreveport, LA 71105 Phone: 318-797-4550 Fax: 318-797-4565 | |
David M. Vieth Dds, A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9018 Mansfield Rd, Shreveport, LA 71118 Phone: 800-920-9947 Fax: 678-247-7858 | |
David Ashley Md Dmd Oral Surgery Group, A Professional Dental Corporat Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 734 N Ashley Ridge Loop, Shreveport, LA 71106 Phone: 337-541-2260 | |
Ivy Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Ashley Ridge Blvd Ste 600, Shreveport, LA 71106 Phone: 318-868-4188 Fax: 318-868-9151 | |
Pediatric Dental Partners, Llp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 318 Carroll St., Shreveport, LA 71105 Phone: 318-865-2250 Fax: 318-865-3751 |