| NPI | 1073607008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM DAVIS Manager 601-825-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 1828-79) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |