| NPI | 1225202062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY EMERSON Office Manager 601-636-6081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2624-91) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |