# NORTH MISSISSIPPI DENTAL SPECIALISTS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** the children's dental center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578658373
- **Authorized official:** DR. CLYDE ARMSTRONG MUSGRAVE D.M.D. (PEDIATRIC DENTIST)
- **Authorized official phone:** (662) 893-7337

## Contact information

- **Practice address:** 2925 NAIL RD E STE 103, SOUTHAVEN, MS 38672-6715
- **Practice address phone:** (662) 893-7337
- **Practice address fax:** (662) 893-7881
- **Mailing address:** 2925 NAIL RD E STE 103, SOUTHAVEN, MS 38672-6715
- **Mailing address phone:** (662) 893-7337
- **Mailing address fax:** (662) 893-7881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3136-00 | MS | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 05/23/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09016069 | — | MS |