| NPI | 1447469069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KENNEDY BROADWELL Dentist, Owner 318-798-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5313) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |