| NPI | 1881088110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL DOMINGUE Partner 337-235-1523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5893) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 3493) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-03-25 |