| NPI | 1598478109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GARRITY Administrator 318-884-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-12-28 |
| Last Update Date | 2022-12-28 |