| NPI | 1568538965 |
|---|---|
| Former Legal Business Name | FAMILY AND COSMETIC DENTISTRY OF JACKSON |
| Entity Type | Organization |
| Authorized Contact | MISTY LEIGH PATEL CFO 731-424-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-06-09 |