| NPI | 1740435668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW MIDDLETON Provider 601-450-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS 3044-98) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2008-11-19 |