| NPI | 1174901722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MONROE BARKSDALE Owner 225-292-8783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 2681) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-05-15 |