| NPI | 1003099839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MANOGIN BENDER Owner 601-362-0460 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2833-94) |
| Enumeration Date | 2007-12-15 |
| Last Update Date | 2021-08-31 |