| NPI | 1649043662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE E VIAL Direc Of Cred And Prov Rel 504-638-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |