Individual
BENJAMIN ANDY SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1067 TWINING DR, BARKSDALE AFB, LA 71110-2486
(318) 456-6718
Mailing address
1067 TWINING DR, BARKSDALE AFB, LA 71110-2486
(318) 456-6718
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
23971
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7519
LA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
7519
LA
Other
Enumeration date
07/13/2009
Last updated
05/27/2025
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