| NPI | 1255007589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Director Of Provider Relations 504-638-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2023-06-06 |