| NPI | 1427145044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA LOUISE LEWIS Owner/Dentist 601-925-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 255990) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2008-07-30 |