| NPI | 1083675946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIE MOREAU GODAIL Owner, Dentist 985-853-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5263) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-08-22 |