| NPI | 1174275762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD V BROWN Owner/Dentist 601-636-3388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-10-28 |