| NPI | 1407364730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINTAGE LEBLANC Owner/President 337-234-8788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5523) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2023-04-19 |