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Organization
CRYSTAL SPRINGS DENTAL CENTER, LLC
Active
Organization
CRYSTAL SPRINGS DENTAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRANCE L WARE DDS (OWNER/OPERATOR)
(901) 282-5706
Entity
Organization
Contact information
Practice address
304 HARMONY RD, CRYSTAL SPRINGS, MS 39059-2809
(901) 282-5706
Mailing address
304 HARMONY RD, CRYSTAL SPRINGS, MS 39059-2809
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3439-07
MS
Other
Enumeration date
12/01/2011
Last updated
12/06/2011
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