| NPI | 1013003243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MICHAEL WARREN Dentist 318-256-3641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4744) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |