Individual
LAKESHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
1067 TWINNING DR., BOSSIER, LA 71110
(318) 456-4018
Mailing address
1067 TWINNING DR., BOSSIER, LA 71110
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3499
LA
124Q00000X
Dental Hygienist
3499-08
LA
Other
Enumeration date
01/03/2007
Last updated
09/12/2008
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