| NPI | 1861441370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BYRON DAVID BASCO Dentist Owner 225-927-5946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 5008) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 5031) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |