| NPI | 1568120194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER KILLEBREW TUTOR Owner 601-292-9772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2022-03-05 |