| NPI | 1841490612 |
|---|---|
| Doing Business As | DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHARLES CARLISLE Hospital Director 601-581-7878 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 31-136) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2020-05-12 |