| NPI | 1386182418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA J GOURI President 337-443-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: LA 5755) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2023-08-08 |