| NPI | 1720509045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA MARIE BROWN Director Of Revenue Cycle 225-266-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2018-09-04 |