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Organization
ARKLATEX ORAL & MAXILLOFACIAL SURGERY A PARTNERSHIP OF PROFESSIONAL DE
Active
Organization
ARKLATEX ORAL & MAXILLOFACIAL SURGERY A PARTNERSHIP OF PROFESSIONAL DE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN R SMITH DDS, MS (PRESIDENT)
(318) 797-5812
Entity
Organization
Contact information
Practice address
7600 FERN AVE, BUILDING 1400, SHREVEPORT, LA 71105-5659
(318) 797-5812
Mailing address
7600 FERN AVE, BUILDING 1400, SHREVEPORT, LA 71105-5659
(318) 797-5812
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/15/2008
Last updated
02/02/2011
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