Individual
MARIA WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2495 SHREVEPORT HWY., ALEXANDRIA, LA 71306-9004
(318) 473-0010
(318) 483-5168
Mailing address
2495 SHREVEPORT HWY., ALEXANDRIA, LA 71306-9004
(318) 473-0010
(318) 483-5168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5587
LA
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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