Individual
DR. HEATHER KOROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2706 RYAN ST, LAKE CHARLES, LA 70601-7328
(337) 944-0313
Mailing address
7231 BURGANDY DR, LAKE CHARLES, LA 70605-0254
(337) 499-0377
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6927
LA
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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