| NPI | 1780805747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA B DARCEY Office Manager 985-873-8451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 3005) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 4366) |
| 122300000X Dentist (Licence: LA 4822) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |