| NPI | 1750596938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A NICHOLSON Orthodontist 601-268-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS 6863) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 194181) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |