| NPI | 1790449247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Director Of Provider Relationd 504-638-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-10-29 |