Individual
DR. BISI JOSEPH EKUNDAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 425-2252
(318) 425-2367
Mailing address
3041 DR MARTIN LUTHER KING DR, SHREVEPORT, LA 71107-4705
(318) 227-3350
(318) 222-2979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
38070
TX
122300000X
Dentist
Primary
6001317-15
WI
122300000X
Dentist
7024
LA
Other
Enumeration date
08/22/2019
Last updated
07/27/2023
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