| NPI | 1285973693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK DEVEREUX Owner 504-368-7513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |