| NPI | 1740385574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A PARKER Dentist President 985-735-7653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3321) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 3321) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2010-11-22 |