| NPI | 1801001433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARNEY BRICE President 228-374-8175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MS 1795-78) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |