Individual
DR. JOHN HERMAN MITCHELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
352 MISSION DRIVE, SIMMESPORT, LA 71369
(318) 941-2071
(318) 941-2629
Mailing address
PO BOX 130, 352 MISSION DRIVE, SIMMESPORT, LA 71369
(318) 941-2071
(318) 941-2629
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3440
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1834408
—
LA
Enumeration date
08/14/2006
Last updated
07/08/2007
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