Kelly Braswell Dds Llc in Shreveport - Dentist
Kelly Braswell Dds Llc - NPI 1700091600
Kelly Braswell Dds Llc is a Dentist in Shreveport, Louisiana. Kelly Braswell Dds Llc practices all healthcare services and medical treatments related to Dentist. The NPI Number for Kelly Braswell Dds Llc is 1700091600. The last update date is 2020-08-22.
Kelly Braswell Dds Llc's current location address is 3718 Jewella Ave, Shreveport, Louisiana. You can contact this provider via phone number 3186366923. The mailing address for Kelly Braswell Dds Llc is 3718 Jewella Ave, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Kelly Braswell Dds Llc |
|---|---|
| Address | 3718 Jewella Ave, Shreveport, Louisiana |
| Phone Number | 3186366923 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER DENT |
|---|---|
| Authorized Official Name | Braswell W Kelly |
| Credentials | DDS |
| Telephone Number | 3186366923 |
NPI Number Detail
| NPI Number | 1700091600 |
|---|---|
| Provider Enumeration Date | 2007-05-14 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 3718 Jewella Ave |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711094704 |
| Phone Number | 3186366923 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | LA4050 |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1840505 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Kelly Braswell Dds Llc by the Centers for Medicare & Medicaid Services?
The Kelly Braswell Dds Llc has been assigned the NPI (National Provider Identifier) 1700091600 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Kelly Braswell Dds Llc's facilities are situated?
The facilities of Kelly Braswell Dds Llc are physically located at the following address: 3718 Jewella Ave, Shreveport, LA, 711094704.
What is Kelly Braswell Dds Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kelly Braswell Dds Llc's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1700091600 to Kelly Braswell Dds Llc?
The Centers for Medicare & Medicaid Services originally issued the 1700091600 to Kelly Braswell Dds Llc on 2007-05-14.
When was the information regarding Kelly Braswell Dds Llc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Kelly Braswell Dds Llc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.
NPI Number: 1053314252
Address: 10220 Prairie Ridge Blvd, Pleasant Prairie, WI
NPI Number: 1720081912
Address: 111 Edgartown Rd, Vineyard Haven, MA