| NPI | 1750546669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBIE N. MORRIS Owner/Dentist 985-532-3480 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 4092) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2016-06-16 |