NPI | 1952572919 |
---|---|
Entity Type | Organization |
Authorized Contact | BRETT A. VALENTINE Owner 601-758-0150 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2752-93) |
Enumeration Date | 2008-03-18 |
Last Update Date | 2008-07-01 |