| NPI | 1629452818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY CHAUVIN President 337-234-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5394) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |