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Organization
RESTORATION DENTAL GROUP LLC
Active
Organization
RESTORATION DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND A JARVIS DDS (OWNER OF RESTORATION DENTAL GROUP L)
(318) 797-1181
Entity
Organization
Contact information
Practice address
2010 E 70TH ST, SHREVEPORT, LA 71105-5306
(318) 797-1181
(318) 797-1180
Mailing address
7607 FERN AVE. SUITE 800, SHREVEPORT, LA 71105
(318) 797-1181
(318) 797-1180
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3384
LA
261QD0000X
Dental Clinic/Center
6042
LA
Other
Enumeration date
06/02/2010
Last updated
07/15/2022
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