| NPI | 1477796977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT WAYNE TUTOR Orthodontist 601-824-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MS 3161-00) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-13 |