| NPI | 1508267691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY B TOUPS Administrator 601-271-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2024-03-19 |