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 |