NPI | 1316035207 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBIN A WILSON Office Manager 601-264-5100 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 1453-71) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2020-08-22 |