| NPI | 1558464123 |
|---|---|
| Doing Business As | CHILDRENS DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | TRICE WARRINER SUMNER Pediatric Dentist Owner 662-844-3315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS PEDO478) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS PEDO34400) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |