| NPI | 1659432755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE D THERIOT Dentist 985-345-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4545) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |