| NPI | 1912123159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER HOOD Practice Manager 601-425-2356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS OS-287-95) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS OS-082-84) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |