| NPI | 1982976817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STASIA D WINFORD Dentist 662-746-3491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 2846-94) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2014-01-28 |