| NPI | 1285771030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT F MCMULLEN President 318-322-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 4293) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 5171) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2009-02-09 |