| NPI | 1356613681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLEY MARION LESTER President 318-631-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 1956) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2012-02-02 |