| NPI | 1932265592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA R GADDIS Owner 601-693-7913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 3155-00) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |