Individual
MICHAEL O. FEAVEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3100 WOODLAWN AVE, SUITE D, SHREVEPORT, LA 71104-4637
(318) 865-3757
(318) 865-3775
Mailing address
3100 WOODLAWN AVE, SUITE D, SHREVEPORT, LA 71104-4637
(318) 865-3757
(318) 865-3775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA3823
LA
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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