| NPI | 1932263506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RANDAL COMEAUX Partner 337-989-0267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: LA 3129) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |