| NPI | 1912671520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Director Of Provider Relations 504-638-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2025-01-02 |