| NPI | 1801136577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LEE WILLIAMS Owner 601-319-1918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS MS 3469-08) |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2013-02-18 |