| NPI | 1699009274 |
|---|---|
| Doing Business As | WESTSIDE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | CHARLES B HOGUE Doctor/Dentist 504-368-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3293) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 4449) |
| 1223G0001X Dentist, General Practice (Licence: LA 5992) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 3771) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |