| NPI | 1962165126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WALTER GREENWOOD Clinical Director 504-952-0344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2021-10-14 |