| NPI | 1902392772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE THIMMESCH Dentist 337-989-1268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: LA 6003) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2022-04-29 |