| NPI | 1538646997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH JOSEPH FABRE Owner 504-615-4799 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: LA 5874) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |