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 |