NPI | 1962686394 |
---|---|
Entity Type | Organization |
Authorized Contact | RODERICK L COLEMAN Owner 601-619-4777 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MS 315300) |
Enumeration Date | 2007-12-20 |
Last Update Date | 2007-12-20 |