| NPI | 1265453138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH SPENCER YOUNG Partner 601-982-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS Pedo 61-83) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS Pedo 1-70) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |