NPI | 1194846667 |
---|---|
Doing Business As | MISSISSIPPI DENTAL GROUP P.C. |
Entity Type | Organization |
Authorized Contact | LAURIE SUMMERS Credentialing 303-285-6098 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6097) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2020-08-22 |