| NPI | 1861691545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ANNE STAMPER Insurance Manager 225-769-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: LA 2306) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |