NPI | 1235276312 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK ANDREW DILLON President 601-876-2176 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS MS2717-93) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2020-08-22 |