| NPI | 1154489557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTI SCANLON Office Manager 601-485-4851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2361) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |