| NPI | 1548761711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN WILLIS ROBERSON President 504-452-5122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: TN 8949) |
| Enumeration Date | 2018-02-23 |
| Last Update Date | 2018-02-23 |