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 |