| NPI | 1114259967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOIRA EASLEY Office Manager 225-924-1824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5193) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2013-01-30 |