| 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 |