| NPI | 1508639535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE E VIAL Direc Of Cred And Prov Rel 504-638-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |