Organization
H. O. BLACKWOOD, D.D.S. APDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ARDOIN (OFFICE MANAGER)
(318) 865-8478
Entity
Organization
Contact information
Practice address
814 PIERREMONT RD, SHREVEPORT, LA 71106-2034
(318) 865-8478
Mailing address
814 PIERREMONT RD, SHREVEPORT, LA 71106-2034
(318) 865-8478
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1612
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1816124
—
LA
Enumeration date
10/09/2007
Last updated
10/09/2007
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