| NPI | 1811624141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Director Of Provider Relations 504-638-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2022-08-05 |