| NPI | 1356553770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L. DONALD, JR. Owner 601-643-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 79556) |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2020-08-22 |