NPI | 1205045549 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW KEYS DULANEY Owner 601-373-1351 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 226886) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2020-08-22 |