Individual
AUDREY BRYCE KORTUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
600 SHRINERS DR, BOGALUSA, LA 70427-2684
(985) 735-0078
Mailing address
5325 FULVETTA FALLS RD, SLIDELL, LA 70461-5242
(501) 786-1297
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7792
LA
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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