| NPI | 1053604892 |
|---|---|
| Doing Business As | PHSC DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CATHERINE M TONORE CEO 318-388-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2021-04-15 |