Individual
MUHANNAD MAHER GHAZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 HEARNE AVE, SHREVEPORT, LA 71103-3934
(182) 128-9103
Mailing address
PO BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S-1225
LA
Other
Enumeration date
04/22/2024
Last updated
06/11/2025
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