| NPI | 1346627874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSY SMITH SIMPSON Owner 601-442-5476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MS MS3519-09) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-05-05 |