| NPI | 1982180279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA COATS Insurance Credentialing Manager 504-609-2599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 5312) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2021-02-08 |