Individual
ROBERT W ROCKEFELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6047 FIVE OAKS DR, SUITE A, SHREVEPORT, LA 71129
(318) 688-9210
(318) 688-9211
Mailing address
6047 FIVE OAKS DR, SUITE A, SHREVEPORT, LA 71129
(318) 688-9210
(318) 688-9211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2505
LA
Other
Enumeration date
10/21/2006
Last updated
07/08/2007
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