| 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 |