| NPI | 1730428772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A MOSAL President 601-956-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 1585-73) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3475-08) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2013-02-12 |