| NPI | 1689968695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN L BERCIER Owner 337-334-3581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 5548) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-24 |