NPI | 1083783419 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTIE LEAH REINE Owner Dentist 985-643-1852 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5503) |
Enumeration Date | 2006-11-07 |
Last Update Date | 2020-08-22 |