| NPI | 1730414830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONEY R FIASCONARO President 318-729-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5754) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2009-10-07 |