Organization
LOUISIANA ORTHODONTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY GREEMON (OFFICE MANAGER)
(318) 688-2225
Entity
Organization
Contact information
Practice address
2530 BERT KOUNS INDUSTRIAL LOOP, SUITE 112, SHREVEPORT, LA 71118-3132
(318) 688-2225
(318) 688-2306
Mailing address
2530 BERT KOUNS INDUSTRIAL LOOP, SUITE 112, SHREVEPORT, LA 71118-3132
(318) 688-2225
(318) 688-2306
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4748
LA
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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