Organization
PALMER AND OBRIEN FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA LYMAN (INSURANCE COORDINATOR)
(318) 868-5726
Entity
Organization
Contact information
Practice address
6150 LINE AVE, SHREVEPORT, LA 71106-2051
(318) 868-5726
(318) 868-7546
Mailing address
6150 LINE AVE, SHREVEPORT, LA 71106-2051
(318) 868-5726
(318) 868-7546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14481
—
LA
Enumeration date
10/09/2019
Last updated
10/09/2019
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