| NPI | 1356604664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE K TURNER Insurance Coordinator 662-234-4822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 305098) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 352209) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 9082) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN 8281) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-12-17 |