| NPI | 1255568549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK DEVEREUX Owner Doctor 504-305-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2015-02-13 |