| NPI | 1669500195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM THOMAS JUDICE Owner 337-988-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3422) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |