| NPI | 1003245226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATRINEL JORDAN Dentist/ Owner 225-673-1557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 6275) |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2014-01-09 |