| NPI | 1740353408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL E BALLARD Owner 601-634-6277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2063-84) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |