| NPI | 1922203306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY DREW KING President 601-823-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 339006) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |