| NPI | 1528657939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY MCGOWIN Office Manager 601-778-0367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2022-07-27 |