| NPI | 1750613840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL BRET SANDERS Owner/Dentist 318-323-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 4654) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 5954) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-02 |