# ARKLATEX ORAL & MAXILLOFACIAL SURGERY A PARTNERSHIP OF PROFESSIONAL DE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003092545
- **Authorized official:** BRIAN R SMITH DDS, MS (PRESIDENT)
- **Authorized official phone:** (318) 797-5812

## Contact information

- **Practice address:** 7600 FERN AVE, BUILDING 1400, SHREVEPORT, LA 71105-5659
- **Practice address phone:** (318) 797-5812
- **Mailing address:** 7600 FERN AVE, BUILDING 1400, SHREVEPORT, LA 71105-5659
- **Mailing address phone:** (318) 797-5812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2008
- **Last updated:** 02/02/2011