| NPI | 1982060661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ARDOIN Business Manager 337-526-7242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: LA 4041) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |