| NPI | 1164681003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE B HOLDER Office Manager 225-927-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 1584) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-05 |