| NPI | 1114055167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN W STARR Periodontist 662-329-2696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: MS PER154-88) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |