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General NPI Number Information
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NPI Number | 1306921002
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Entity Type | Organization
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Legal Business Name | DR. LEAH V. BYLES, A DENTAL CORPORATION
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 720 SHREVEPORT HWY
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City | MANY
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State | LA
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Zip | 71449-2612
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Country | US
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Telephone | 318-256-5430
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Fax | 318-256-5432
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Provider Business Mailing Address
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Address Line | PO BOX 1004 720 SHREVEPORT HWY
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City | MANY
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State | LA
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Zip | 71449-1004
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Country | US
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Telephone | 318-256-5430
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Fax | 318-256-5432
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA HOLLOWAY
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Credential | D.D.S.
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Telephone | 318-256-5430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5390
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License Number State | LA
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