NPI | 1396198248 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE HENTON ROBERTS Owner/Dentist 318-259-4161 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3857) |
Enumeration Date | 2016-07-15 |
Last Update Date | 2016-07-15 |