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

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

## Provider details

- **NPI number:** 1588170112
- **Authorized official:** HALEY WOOSTER (ENROLLMENT SPECIALIST)
- **Authorized official phone:** (984) 251-8846

## Contact information

- **Practice address:** 170 NORTHSHORE BLVD STE B, SLIDELL, LA 70460-6820
- **Practice address phone:** (985) 500-3155
- **Practice address fax:** (985) 643-6987
- **Mailing address:** 170 NORTHSHORE BLVD STE B, SLIDELL, LA 70460-6849
- **Mailing address phone:** (985) 500-3155
- **Mailing address fax:** (985) 643-6987

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2017
- **Last updated:** 04/13/2026