Individual
ZACHARY MICHAEL MUTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3410
(318) 686-7470
Mailing address
24 DUCK HAVEN PT, BOSSIER CITY, LA 71111-8173
(314) 249-6557
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7611
LA
Other
Enumeration date
04/17/2023
Last updated
06/16/2025
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