| NPI | 1932583358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE G MISURACA Owner 225-673-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: LA 5051) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2016-08-19 |