| NPI | 1568663029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN E JOHNSTON President Of Company 601-825-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 1756) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-02-22 |