| 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 |