Organization
HORSESHOE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY WALLER SHERMAN II DDS (DENTIST)
(318) 228-9911
Entity
Organization
Contact information
Practice address
164 COUNTRY CLUB CIRCLE, SUITE A, MINDEN, LA 71055-7502
(318) 639-9559
(318) 639-9560
Mailing address
164 COUNTRY CLUB CIRCLE, SUITE A, MINDEN, LA 71055-7502
(318) 639-9559
(318) 639-9560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5738
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5738
DENTIST
LA
Enumeration date
05/18/2016
Last updated
05/18/2016
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