| NPI | 1194021022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BALLEW CARLTON General Dentist 601-653-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3503-09) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2015-11-30 |