| NPI | 1407972268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE BLANCHARD MITCHELL Accounts Manager 225-292-6991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 3141) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |