| NPI | 1750181632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DANIEL RAYMOND Owner 318-537-3182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-04-21 |