# SHANE TEWIS, DDS OF LOUISIANA, A PROFESSIONAL DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Affordable Dentures & Implants - Lake Charles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023556370
- **Authorized official:** HALEY WOOSTER (ENROLLMENT MANAGER)
- **Authorized official phone:** (984) 251-8846

## Contact information

- **Practice address:** 2625 DILLARD LOOP, STE A, LAKE CHARLES, LA 70607
- **Practice address phone:** (337) 242-1800
- **Mailing address:** 2625 DILLARD LOOP STE A, LAKE CHARLES, LA 70607-7721
- **Mailing address phone:** (337) 242-1800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6219 | LA | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2017
- **Last updated:** 04/13/2026