| NPI | 1346015385 |
|---|---|
| Doing Business As | JACKSON DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | KENNETH ANTHONY BAILEY Owner/Dentist 601-981-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |