| NPI | 1063792752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRETTA RRENEE PORTER-WILLIAMS Owner 318-868-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4645) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |