| NPI | 1336331990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY LOUIS GROB Orthodontist 985-626-4779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 2058) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2007-08-16 |