| NPI | 1952522237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY D LACOM President Dentist 662-286-5991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 287795) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |