NPI | 1306279039 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN ANTHONY IENNUSA President/Orthodontist 985-626-4779 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5188) |
Enumeration Date | 2013-08-16 |
Last Update Date | 2013-08-16 |