| NPI | 1740411792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL HART SANDERS Owner 985-876-5430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4648) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |