NPI | 1417407404 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES RANDALL WOODSON Owner 601-988-6200 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3200-01) |
Enumeration Date | 2016-10-13 |
Last Update Date | 2016-10-13 |