Individual
JIM PICHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
5922 WILDCREST ST, BOSSIER CITY, LA 71111-5620
(903) 372-3340
Mailing address
5922 WILDCREST ST, BOSSIER CITY, LA 71111-5620
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40377
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2022
Last updated
01/03/2025
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