NPI 1245906148

Shreveport Center for Oral and Facial Surgery, L.L.C.

Organisation Oral & Maxillofacial Surgery (D.M.D.) Shreveport, LA

Practice location

Address: 915 Shreveport Barksdale Hwy, Shreveport, LA 71105-2205
Phone: (318) 865-0249
Fax: (318) 869-0026

Authorised official

Name: Wesley D. Carlisle
Title: Oral and Maxillofacial Surgeon
Phone: (318) 865-0249

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X

Other Oral & Maxillofacial Surgery providers in Louisiana →

Oral and Maxillofacial Surgery (Dentist)

Dental Providers Taxonomy 1223S0112X

Other Dentist providers in Louisiana →

Registry record

NPI: 1245906148
Entity type: Organization
NPI issued: 19 Aug 2021
Record last updated: 19 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.