| NPI | 1689479248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALLACE S MCLAURIN Owner/Operator 601-259-6739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-02-18 |