| NPI | 1427327725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L DAVIS Dentist/Owner 228-863-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 334905) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2021-05-20 |