| NPI | 1073234985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ASHLEY JOHNSON Owner/Dentist 318-346-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |