| NPI | 1881708568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R LEDOUX President/Owner 985-674-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 2993) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 2081) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2022-08-02 |