| NPI | 1851543250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R NICHOLS President 601-420-3223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MS OS34000) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |