Individual
ROSS DAVID BROCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 410, SHREVEPORT, LA 71118-3157
(318) 212-5944
(318) 212-5949
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 410, SHREVEPORT, LA 71118-3157
(318) 212-5944
(318) 212-5949
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
331336
LA
Other
Enumeration date
06/07/2017
Last updated
05/01/2025
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