| NPI | 1225256332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONAS E GAUTHIER Owner 318-448-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 4961) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-06-09 |