| NPI | 1871706564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN MARIE HUNTER-MOORE Dentist 601-693-4878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 267892D) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2017-02-02 |