| NPI | 1235339284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH WREN Owner 601-824-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS PEDO-402-07) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |