| NPI | 1902529431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA PAIGE VOLENTINE Owner 318-255-7946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2024-12-10 |