| NPI | 1548673320 |
|---|---|
| Doing Business As | PARK PLACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | KEN G GOODWIN Owner 662-728-8171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 1971-82) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-06-09 |