| NPI | 1588028856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN THOMAS LITTLE Owner/Dentist 318-435-4694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 4085) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 6059) |
| 124Q00000X Dental Hygienist (Licence: LA 4623) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |