| NPI | 1467665505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK P DEVEREUX Owner And Orthodontist 504-368-7513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 3676) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: LA 5714) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2013-05-24 |