| NPI | 1942550470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYON C GANUCHEAU President 504-887-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 4959) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 5403) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |