| NPI | 1639235963 |
|---|---|
| Doing Business As | PEDIATRIC DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | LORI ORFANS Offc Mgr 662-349-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-02-23 |