| NPI | 1851040612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA MAESTRI Owner 337-704-2126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2023-09-20 |