| NPI | 1932621943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LESTER Dentist/Owner 318-443-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: LA 5649) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: LA 5790) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2022-07-21 |