| NPI | 1306190285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BRENT THOMAS Dentist 601-638-2361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 195381) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |