JOHN W WATERFALLEN , MD in SHREVEPORT - NPI - 1164417309
JOHN W WATERFALLEN is a dentist based out of SHREVEPORT,Louisiana JOHN practices in SHREVEPORT,Louisiana and has the professional credentials of MD .The NPI Number for JOHN W WATERFALLEN is 1164417309 and he holds a Licence No. 14123(Louisiana).
JOHN current practice location address is 7941 YOUREE DR,,SHREVEPORT,Louisiana and he can be reached out via phone at 3187977941 and via fax at3187977991. You can also correspond with JOHN W WATERFALLEN through mail at his mailing address at7941 YOUREE DR,,SHREVEPORT,Louisiana – 711055538 (mailing address contact number – 711055538).
Provider Profile Details
| NPI Number | 1164417309 |
| Provider Name | JOHN W WATERFALLEN |
| MD | |
| Gender | 39271 |
| Provider Entity Type | Individual |
| Provider Enumeration Date | 207V00000X |
| Last Update Date | 38609 |
Provider Business Mailing Address Details
| Address | 7941 YOUREE DR, |
| City | SHREVEPORT |
| State | Louisiana |
| Zip | 711055538 |
| Phone Number | 3187977941 |
Provider Business Practice Location Address Details
| Address | 7941 YOUREE DR, |
| City | SHREVEPORT |
| State | Louisiana |
| Zip | 711055538 |
| Phone Number | 3187977941 |
Provider's Primary Taxonomy Details
| Taxonomy | 207V00000X |
| License No. | 14123 |
| State | Louisiana |