| NPI | 1215432463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD BROWN Owner 985-400-2460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS 3502) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |