| NPI | 1578777108 |
|---|---|
| Other Name | FAMILY DENTISTRY OF BOGALUSA |
| Entity Type | Organization |
| Authorized Contact | CHARLIE P ILAWAN Owner 985-735-7372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4361) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-11-04 |