Organization
SPD LLC
Active
Other names
Southern Pines Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE GRESHAM DDS (MEMBER)
(318) 855-1426
Entity
Organization
Contact information
Practice address
1416 HAZEL ST, ARCADIA, LA 71001-4114
(318) 855-1426
(318) 579-5038
Mailing address
1416 HAZEL ST, ARCADIA, LA 71001-4114
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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