| NPI | 1063759736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOHN MELANCON Owner/Dentist 337-837-1861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5974) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |