| NPI | 1710125216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN E PFINGSTEN Member 985-892-3250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 5054) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 5768) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |