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Individual

DR. BENJAMIN COLE FOSTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1914 E 70TH ST, SHREVEPORT, LA 71105-5312
(318) 797-8833
Mailing address
620 SOUTHERN TRACE PKWY, SHREVEPORT, LA 71106-9323
(318) 458-2067

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6090
LA

Other

Enumeration date
10/21/2011
Last updated
10/21/2011
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