| NPI | 1396963740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL K. MARTISIUS Owner Doctor 318-388-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 4436) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2013-10-07 |