| NPI | 1790069854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER B. PARKES Owner/Dentist 601-956-1230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MS 1845-79) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MS 2364-87) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |