| NPI | 1437520285 |
|---|---|
| Former Legal Business Name | JUBAN CROSSING MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JACOB DENT Owner Doctor 225-788-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2015-10-19 |