# LOUD FAMILY DENTAL

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

## Provider details

- **NPI number:** 1639607104
- **Authorized official:** MISS AHIDA OCHILL (OFFICE MANAGER)
- **Authorized official phone:** (318) 631-3464

## Contact information

- **Practice address:** 2701 FREDERICK ST, SHREVEPORT, LA 71109-3607
- **Practice address phone:** (318) 631-3464
- **Practice address fax:** (318) 631-3474
- **Mailing address:** 2701 FREDERICK ST, SHREVEPORT, LA 71109-3607
- **Mailing address phone:** (318) 631-3464
- **Mailing address fax:** (318) 631-3474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5534 | LA | Yes |
| 1223G0001X | General Practice Dentistry | 6613 | LA | — |

## Other

- **Enumeration date:** 05/30/2017
- **Last updated:** 07/21/2022