| NPI | 1558418897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD RAY HARRISON Dentist 601-947-9530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2485) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |