| NPI | 1134246630 |
|---|---|
| Former Legal Business Name | TUPELO SMILES |
| Entity Type | Organization |
| Authorized Contact | JOHN P KENNEY Partnership 662-840-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2011-08-25 |