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Individual

DR. BRENTON D. BIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2119 AIRLINE DR STE 700, BOSSIER CITY, LA 71111-3684
(318) 686-7470
Mailing address
910 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3410
(318) 686-7470

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6954
LA

Other

Enumeration date
04/04/2019
Last updated
05/28/2019
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