| NPI | 1366822710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGER WHITTINGTON Insurance Clerk 318-688-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5831) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |