Individual
DR. JOHN C. SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
113 PROFESSIONAL DR, WEST MONROE, LA 71291-5331
(318) 325-5423
(318) 387-7080
Mailing address
113 PROFESSIONAL DR, WEST MONROE, LA 71291-5331
(318) 325-5423
(318) 387-7080
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3594
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1835943
—
LA
01
—
720920909
TAX ID
LA
Enumeration date
08/21/2006
Last updated
05/27/2009
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