| NPI | 1386738391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M. BURTON Manager 601-824-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 2332-87) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-11-13 |