| NPI | 1487790929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHARLES THERIOT Owner Dentist 337-984-3408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5429) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |