| NPI | 1033412176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA G JONES Dentist 228-760-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 2022-83) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |