| NPI | 1720465776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH H ALFORTISH Dentist 504-368-2792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 4524) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |