| NPI | 1881901726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M GREGSON Owner 504-849-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: LA 3148) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2019-05-10 |