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Organization
SOUTHFIELD FAMILY DENTISTRY, INC.
Active
Organization
SOUTHFIELD FAMILY DENTISTRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN SHERIDAN FENTON D.D.S. (OWNER)
(318) 868-5115
Entity
Organization
Contact information
Practice address
230 CARROLL ST, SUITE 5, SHREVEPORT, LA 71105-4248
(318) 868-5115
(318) 868-5114
Mailing address
230 CARROLL ST, SUITE 5, SHREVEPORT, LA 71105-4248
(318) 868-5115
(318) 868-5114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4009
LA
Other
Enumeration date
10/04/2006
Last updated
02/08/2017
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