| NPI | 1689143083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ACACIA RENEE ACCARDO Insurance Coordinator 318-322-2013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2018-11-15 |