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Organization
SR BOSSIER LLC
Active
Organization
SR BOSSIER LLC
Active
Other names
Southern Roots Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ABIGAIL RENEE HOWELL (PRACTICE MANAGEMENT)
(318) 294-2241
Entity
Organization
Contact information
Practice address
2369 AIRLINE DR STE 330, BOSSIER CITY, LA 71111-5867
(318) 658-9622
(318) 658-9628
Mailing address
2369 AIRLINE DR STE 330, BOSSIER CITY, LA 71111-5867
(318) 658-9622
(318) 658-9628
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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