| NPI | 1598282162 |
|---|---|
| Doing Business As | SOUTHERN MAGNOLIA SMILES |
| Entity Type | Organization |
| Authorized Contact | KARI E LEWIS Office Manager 228-215-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MS 3600-11) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2022-07-21 |