Individual
ASHLEY HABETZ HORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL STUDENT
Contact information
Practice address
910 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3410
(318) 686-7470
Mailing address
999 ROCHEL DR, SHREVEPORT, LA 71115-3876
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6961
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Enumeration date
04/10/2019
Last updated
05/20/2019
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