| NPI | 1174009633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA COATS Insurance Credentialing Manager 504-609-2599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2021-02-08 |