Individual
QI RONG CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(714) 310-6851
Mailing address
531 FOREST AVE, SHREVEPORT, LA 71104-4403
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS110372
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2022
Last updated
01/03/2025
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