| NPI | 1306018619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | T. PALMER WILKS President 601-856-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MS 2304-86) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-03-26 |