Organization
MICHAEL E WOOLBERT DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDWARD WOOLBERT DDS (MANAGER)
(318) 868-8276
Entity
Organization
Contact information
Practice address
7600 FERN AVENUE, BUILDING 1100, SHREVEPORT, LA 71105
(318) 868-8276
(318) 868-8212
Mailing address
7600 FERN AVENUE, BUILDING 1100, SHREVEPORT, LA 71105
(318) 868-8276
(318) 868-8212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4020
LA
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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