| NPI | 1770646598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES H. PERKINS Partner Managing 662-513-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS 3306-04 PEDO-397-06) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2010-10-21 |