| NPI | 1326382680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WILLIAMS Principle 318-547-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 6242) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2013-10-01 |