| NPI | 1821486739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN LOESCHER Managing Member 985-643-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4795) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |