| NPI | 1619600269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA R PATEL Owner Dentist 601-540-8789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2022-07-01 |