Individual
DR. MICHAEL ANGELO GRECO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
111 FREESTATE BLVD, SUITE 108, SHREVEPORT, LA 71107-6540
(318) 221-8002
(318) 221-4447
Mailing address
111 FREESTATE BLVD, SUITE 108, SHREVEPORT, LA 71107-6540
(318) 221-8002
(318) 221-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3687
LA
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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