| NPI | 1295380418 |
|---|---|
| Doing Business As | PROFESSIONAL DENTURE CLINIC |
| Entity Type | Organization |
| Authorized Contact | ERINN PUMPHREY DUDLEY Bookkeper 318-422-0397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |