Organization
KOGA ORTHODONTICS LLC
Active
Other names
Koga Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISEANE KOGA DDS/MSD (ORTHODONTIST)
(269) 985-8168
Entity
Organization
Contact information
Practice address
2124 FORSYTHE AVE, MONROE, LA 71201-3611
(318) 388-4209
Mailing address
2124 FORSYTHE AVE, MONROE, LA 71201-3611
(318) 388-4209
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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