Individual
DR. MASON COPELAND LILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4279 HIGHWAY 15, MANGHAM, LA 71259-5189
(318) 248-4986
Mailing address
201 MEDALIST RD, MONROE, LA 71203-8150
(318) 614-5251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7199
LA
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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