| NPI | 1407053531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE LEBLANC Vice President 985-320-4576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA LA2728) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-22 |