Individual
DR. KATHRYN ELIZABETH BEAUREGARD-SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
8510 LINE AVE, SHREVEPORT, LA 71106-6119
(318) 869-3111
(318) 869-3187
Mailing address
8510 LINE AVE, SHREVEPORT, LA 71106-6119
(318) 869-3111
(318) 869-3187
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5168
LA
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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