| NPI | 1104689314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE V DASCH Direc Of Cred And Prov Rel 504-638-0303 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-01-31 |