| 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 |