# PEDIATRIC DENTAL GROUP OF HATTIESBURG, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013210624
- **Authorized official:** CHARLES LINDSEY BELKNAP DMD (DENTIST)
- **Authorized official phone:** (601) 450-6060

## Contact information

- **Practice address:** 6643 US HIGHWAY 98, HATTIESBURG, MS 39402-8442
- **Practice address phone:** (601) 450-6060
- **Practice address fax:** (601) 450-6062
- **Mailing address:** 6643 US HIGHWAY 98, HATTIESBURG, MS 39402-8442
- **Mailing address phone:** (601) 450-6060
- **Mailing address fax:** (601) 450-6062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3044-98 | MS | Yes |
| 1223P0221X | Pediatric Dentistry | 3394-06 | MS | — |

## Other

- **Enumeration date:** 12/21/2010
- **Last updated:** 12/21/2010