| NPI | 1174852875 |
|---|---|
| Doing Business As | PINECREST DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | PAXTON E. OLIVER Mr/Dd Regional Assoc. Administrator 318-487-5395 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |