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 |