| NPI | 1851512388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY GREEMON Office Manager 318-688-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: LA 4748) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |