Individual
CYNTHIA M MICIOTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2158 AIRLINE DR, BOSSIER CITY, LA 71111-3106
(318) 747-1690
(318) 747-9711
Mailing address
2158 AIRLINE DR, BOSSIER CITY, LA 71111-3106
(318) 747-1690
(318) 747-9711
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LA3784
LA
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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