| NPI | 1356717714 |
|---|---|
| Doing Business As | MAGNOLIA FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARK FITZHUGH BRELAND Manager 601-540-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3592-11) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-25 |