| 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 |