| NPI | 1831377134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM H. DAVIS Medical Biller 601-939-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 331104) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2020-11-06 |