| NPI | 1730962234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W MICHAELIS Orthodontist 985-674-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |