| NPI | 1265615181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C. HUMPHREYS Owner/Dentist 601-450-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 3329-05) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |