| NPI | 1083087043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE J ANDREWS Owner/Manager 985-764-1148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 3800) |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2015-11-12 |