| NPI | 1396102174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MARTIN HANNAMAN Owner 337-474-4892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6155) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2016-01-25 |