| NPI | 1497054613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANDY L PARISH Office Manager 318-687-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2011-03-28 |