| NPI | 1790991784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZAN A GUIDRY Office Manager 225-687-4892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3962) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2013-05-03 |