| NPI | 1013033851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON ANDERSON Owner 601-366-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS MS2164-85) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |