| NPI | 1386845063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA D. FONTENOT Secretary Treasurer 337-527-3932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 2102) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |