| NPI | 1710127311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER KYLE BASS President 601-765-4355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3287) |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2009-02-23 |