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WK ORAL AND MAXILLOFACIAL SURGERY INSTITUTE NPI 1104584515


NPI Information

NPI: 1104584515
Provider Name: WK ORAL AND MAXILLOFACIAL SURGERY INSTITUTE
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
2508 BERT KOUNS INDUSTRIAL LOOP STE 410
SHREVEPORT, LA
ZIP 71118
Phone: (318) 716-4939
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WK ORAL AND MAXILLOFACIAL SURGERY INSTITUTE is an oral and maxillofacial surgery dentist in Shreveport, LA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. WK ORAL AND MAXILLOFACIAL SURGERY INSTITUTE NPI is 1104584515. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2508 BERT KOUNS INDUSTRIAL LOOP STE 410
SHREVEPORT, LA
ZIP 71118-157
Phone: (318) 716-4939

The provider's authorized official is Mary Jane Ward .
The authorized official title is Senior Vp Finance and has the following contact phone number (318) 716-4937.

The enumeration date for this NPI number is 12/2/2021 and was last updated on 12/2/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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