| NPI | 1003939570 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DAVID J BELLEW CEO Owner 318-797-4550 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3757) | 
| Enumeration Date | 2007-04-09 | 
| Last Update Date | 2020-08-22 |