| NPI | 1235301995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN JEMISON HODGES Owner 601-583-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MS 3235-02) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |