Organization
KOOL SMILES
Active
Other names
UAB hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSIE DIXON DDS (GENERAL DENTIST)
(678) 285-4807
Entity
Organization
Contact information
Practice address
3719 JEWELLA AVE, SHREVEPORT, LA 71109-4703
(318) 759-0905
Mailing address
3719 JEWELLA AVE,, SHREVEPORT, LA 71109
(318) 573-9918
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6698
LA
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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