NPI | 1457492878 |
---|---|
Other Name | GARY V DEWITT DDS MS A PROFESSIONAL CORPORATION |
Entity Type | Organization |
Authorized Contact | GARY VAN DEWITT Owner Periodontist 318-443-0505 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: LA 3271) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2013-06-26 |