| NPI | 1598171720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY BORDELON STANFORD General Dentist 337-298-0673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DN20769) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |