| NPI | 1639484983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM TYLER HEATH Owner/President 318-728-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5110) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |