| NPI | 1386866739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM NICHOLS Owner, President 337-991-0766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3864) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |