Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 021634 | LA |
NPI | 1134124712 |
---|---|
Provider Name | Dr. Christopher John Saal |
First Address | Houma, LA 70360-6011 |
Second Address | Houma, LA 70360-6011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 23/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1840050 | (05) | LA |
F65659 | (02) | LA |