| NPI | 1578038162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE BIONDO Dentist/Owner 985-446-3855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2018-10-10 |