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1447469622
JAMES WALLACE BRANTLEY
JACKSON, MS
NPI
1447469622
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MS 179478)
Enumeration Date
2007-05-22
Last Update Date
2007-07-08
Business Address
Mr. JAMES WALLACE BRANTLEY DMD
5685 HWY 18 WEST
JACKSON, MS 39209-9622
Phone number: 603-373-2404
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Mailing Address
Mr. JAMES WALLACE BRANTLEY DMD
5685 HWY 18 WEST
JACKSON, MS 39209-9622
Phone number: 603-373-2404
Copy
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