| NPI | 1780301036 |
|---|---|
| Doing Business As | LIVE OAK PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TYLER MESA Owner/Pediatric Dentist 985-705-8144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-10-26 |