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1679024442
LIFETIME DENTAL LLC
GREENWOOD, MS
NPI
1679024442
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Entity Type
Organization
Authorized Contact
DARYL LANCE JOHNSON
Sole Proprietor
662-843-8353
Organization Subpart ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: MS 2826-94)
Enumeration Date
2016-10-17
Last Update Date
2016-10-17
Business Address
LIFETIME DENTAL LLC
910 MEDALLION DR
GREENWOOD, MS 38930-2118
Phone number: 662-843-8353
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Mailing Address
LIFETIME DENTAL LLC
1313 W HIGHWAY 8
CLEVELAND, MS 38732-2240
Phone number: 662-843-8353
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