| NPI | 1942442769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE THERIOT Office Manager 337-258-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 5429) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 5739) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |