| NPI | 1679580518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELDER E WALLACE Dentist/Co Owner 601-264-5756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 1771.77) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2017-10-02 |