NPI | 1891896148 |
---|---|
Entity Type | Organization |
Authorized Contact | PAUL A CLARK VP 985-624-5449 |
Organization Subpart ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA LA4476) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2020-08-22 |