| NPI | 1831398304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL ZERANGUE SIMON Manager 337-857-5837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 5596) |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2012-03-15 |