# NORTH SUNFLOWER MEDICAL CENTER DENTISTS

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

## Provider details

- **NPI number:** 1104037738
- **Authorized official:** MR. JOSE DANIEL CEJA (CEO)
- **Authorized official phone:** (662) 756-2711

## Contact information

- **Practice address:** 840 N OAK AVE, RULEVILLE, MS 38771-3227
- **Practice address phone:** (662) 756-2711
- **Practice address fax:** (662) 756-0306
- **Mailing address:** PO BOX 369, RULEVILLE, MS 38771-0369
- **Mailing address phone:** (662) 756-1601
- **Mailing address fax:** (662) 756-0306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | MS | Yes |

## Other

- **Enumeration date:** 05/25/2007
- **Last updated:** 06/08/2020