NPI | 1194262709 |
---|---|
Former Legal Business Name | MAGNOLIA DENTAL PLLC |
Entity Type | Organization |
Authorized Contact | WILLIAM PERCY DICKEY Owner/Partner 601-597-3490 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3125-00) |
Enumeration Date | 2017-01-21 |
Last Update Date | 2017-01-21 |