| NPI | 1578867115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J NEELY Dentist 601-925-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 228886) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2013-07-24 |