| NPI | 1386116499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA COATS Insurance Credentialing Specilist 504-609-2599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-31 |
| Last Update Date | 2021-02-26 |