Individual
DR. FAWAZ ALOTAIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7144
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
7144
LA
Other
Enumeration date
09/09/2013
Last updated
11/12/2024
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