NPI | 1790175701 |
---|---|
Doing Business As | UPTOWN DENTAL |
Entity Type | Organization |
Authorized Contact | MELISSA GRAY TOM Manager/Dentist 225-413-0022 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5985) |
Enumeration Date | 2015-01-28 |
Last Update Date | 2015-01-28 |