| NPI | 1851725816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JACKSON VAN METER Oral Surgeon 601-825-0021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS OS-466-13) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |