Organization
VIVIAN DENTAL
Active
Parent organization
NORTH CADDO HOSPITAL SERVICE DISTRICT
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH CADDO HOSPITAL SERVICE DISTRICT
Authorized official
BRENT LEONARD (FINANCIAL ANALYST)
(318) 375-4099
Entity
Organization
Contact information
Practice address
815 S PINE ST, VIVIAN, LA 71082-3314
(318) 375-4001
Mailing address
PO BOX 792, VIVIAN, LA 71082-0792
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
12/16/2021
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