| NPI | 1972247328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Director Of Provider Relations 504-638-0303 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2022-04-22 |