| NPI | 1043815855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY A POWELL Office Manager 601-261-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2020-12-21 |