| NPI | 1104058049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET WARNOCK Office Manager 225-769-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: LA 2719) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2009-08-11 |