| NPI | 1992095780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID F DAVENPORT Owner/Dentist 985-662-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: LA 5713) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |