| NPI | 1205138708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J PATTI Owner 601-833-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2010-12-03 |