| NPI | 1689738833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA NICOLE HARRISON Owner Dentist 601-774-9949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3001-97) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |