Healthcare Provider Details

I. General information

NPI: 1588727911
Provider Name (Legal Business Name): SHELBY ANN GEBBS POSNER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W HWY 22 SUITE F
MADISONVILLE LA
70447
US

IV. Provider business mailing address

209 W HWY 22 SUITE F
MADISONVILLE LA
70447
US

V. Phone/Fax

Practice location:
  • Phone: 985-845-3211
  • Fax: 985-845-2895
Mailing address:
  • Phone: 985-845-3211
  • Fax: 985-845-2895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number4351
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: