| NPI | 1760818017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES VICTOR IVERSTINE Owner 318-757-4561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3678-12) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |