| NPI | 1285776872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN ASHLEY JOHNSON Dentist/Owner 318-346-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2023-06-19 |