| NPI | 1093035081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND A JARVIS Owner Of Restoration Dental Group L 318-797-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: LA 3384) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: LA 6042) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2022-07-15 |