Individual
DR. MICHAEL EDWARD WOOLBERT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3100 WOODLAWN AVE, SUITE C, SHREVEPORT, LA 71104-4637
(318) 868-8276
(318) 868-8212
Mailing address
3100 WOODLAWN AVE, SUITE C, SHREVEPORT, LA 71104-4637
(318) 868-8276
(318) 868-8212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4020
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1840203
—
LA
Enumeration date
04/27/2006
Last updated
07/09/2007
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